Antimicrobial resistance associated with the treatment of bacterial vaginosis - 25/08/11
, Michele N. Austin b, Leslie A. Meyn, MS c, Marijane A. Krohn, PhD b, c, Sharon L. Hillier, PhD b, c
Reprint requests: Richard H. Beigi, MD, MSc, Department of Obstetrics and Gynecology, MetroHealth Medical Center, 2500 MetroHealth Dr, Cleveland, OH 44109-1998.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.
Le texte complet de cet article est disponible en PDF.Key words : Bacterial vaginosis, Antimicrobial resistance, Clindamycin, Metronidazole
Plan
| Supported by an unrestricted research grant from 3M Pharmaceuticals and NIH/NIAID U0I AI47785 (CRC MO1 RR00056) |
Vol 191 - N° 4
P. 1124-1129 - octobre 2004 Retour au numéro
Article précédent
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