Antimicrobial resistance associated with the treatment of bacterial vaginosis.

Abstract

OBJECTIVE:

This study was undertaken to evaluate antimicrobial susceptibility of vaginal anaerobic bacteria before and after treatment of bacterial vaginosis.

STUDY DESIGN:

A randomized clinical trial of 119 nonpregnant women with bacterial vaginosis receiving either intravaginal metronidazole for 5 days or clindamycin for 3 days was performed. Women had 1 baseline and 3 follow-up visits at which quantitative vaginal cultures were performed. Anaerobic isolates underwent antimicrobial susceptibility testing.

RESULTS:

Complete susceptibility data was available on 95 women (47 metronidazole and 48 clindamycin). Of 1059 anaerobic bacterial isolates, less than 1% demonstrated resistance to metronidazole. In contrast, 17% demonstrated baseline clindamycin resistance, and 53% demonstrated resistance to clindamycin after therapy. Women exposed to clindamycin (but not metronidazole) had high frequencies (80%) of clindamycin-resistant anaerobic bacteria that persisted for 90 days after treatment.

CONCLUSION:

Treatment of bacterial vaginosis with clindamycin is associated with marked evidence of antimicrobial resistance among vaginal anaerobic bacteria. This may increase the vaginal reservoir of macrolide-resistant bacteria.

• Authors: Richard H Beigi, Michele N Austin, Leslie A Meyn, Marijane A Krohn, Sharon L Hillier
• Journal: American journal of obstetrics and gynecology (Am J Obstet Gynecol) Vol. 191 Issue 4 Pg. 1124-9 (Oct 2004) ISSN: 0002-9378 [Print] United States
• PMID: 15507930 (Publication Type: Clinical Trial, Comparative Study, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't, Research Support, U.S. Gov't, P.H.S.)

Chemical References

• Anti-Bacterial Agents
• Anti-Infective Agents
• Metronidazole
• Clindamycin

Topics

• Adolescent
• Adult
• Anti-Bacterial Agents (therapeutic use)
• Anti-Infective Agents (therapeutic use)
• Clindamycin (therapeutic use)
• Drug Resistance, Bacterial
• Female
• Humans
• Metronidazole (therapeutic use)
• Microbial Sensitivity Tests
• Middle Aged
• Vaginosis, Bacterial (drug therapy, microbiology)