[Trovafloxacin in gynecology]

Presence of microorganisms in the female lower genital tract (LGT) in concentrations that modify the established normal equilibrium produce different symptoms that make necessary to consult the gynecologist. It is currently accepted that infections of the LGT are due to microorganisms that are normally integrating the internal flora, except for the erroneously called "sexually transmitted diseases" that are caused by external microorganisms. This means that all those microorganisms usually present without causing any disease manifestations may, under certain circumstances and determined concentrations, originate or be associated to infections. Lactobacillus sp. and Corynebacterium sp. are normally the most frequent microorganisms in the vagina together with Streptococcus (aerobe), Streptococcus agalactiae and others like Enterococcus, Peptostreptococcus, Bacteroides sp., Bacteroides fragilis, Bacteroides melaninogenicus, Pseudomonas, Klebsiella, Fusobacterium, Escherichia coli. Different antibiotic schemes are proposed for different infections (bacterial vaginosis, gonococcia, chlamydial infections, pelvic inflammatory disease). They are discussed in different sections. Trovafloxacin has shown to be effective in the treatment of infections due to Chlamydia with excellent clinical results and a good tolerance. It was effective as single dose therapy in the treatment of acute gonococcia with therapeutic success in 99% of the treated patients. New fluoroquinolones are also effective in the treatment of infections due to aerobial pathogens. The use of trovafloxacin in the treatment of pelvic inflammatory disease would present great advantages: on one hand, it would cover the wide spectrum of microorganisms responsible for the infection and, on the other, would permit an early switch to oral therapy once the acute phase is over.