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The effect of treatment regimens for vaginitis and cervicitis on vaginal colonization by lactobacilli
1Department of Obstetrics and Gynecology, University of Washington, Seattle, USA.
Background And Objectives:
The goal of this study was to determine the effect of various treatment regimens on vaginal colonization by H2O2-positive and H2O2-negative lactobacilli.
Study Design:
The subset of women enrolled in a large longitudinal cohort study who had Chlamydia trachomatis (n = 13), bacterial vaginosis (n = 105), yeast vaginitis (n = 15), or mucopurulent cervicitis (n = 47) were compared with 93 women without genital infection from the same population. The effect of various treatment regimens on lactobacilli was evaluated.
Results:
Use of doxycycline, azithromycin, clotrimazole, and fluconazole had little effect on vaginal colonization by Lactobacillus. Use of oral or vaginal metronidazole led to an increase in Lactobacillus, which persisted 1 month after therapy. Intravaginal clindamycin use caused a decrease 1 week post-therapy, but at 1 month, levels of lactobacilli were similar to those in the metronidazole treatment group. Women treated with oral ampicillin had a modest increase in Lactobacillus levels.
Conclusions:
Use of antimicrobial agents for treating vaginitis and cervicitis do not cause a decrease in vaginal colonization by Lactobacillus, which is detectable 1 week to 1 month after treatment.