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Pefloxacin
Published in M. Lindsay Grayson, Sara E. Cosgrove, Suzanne M. Crowe, M. Lindsay Grayson, William Hope, James S. McCarthy, John Mills, Johan W. Mouton, David L. Paterson, Kucers’ The Use of Antibiotics, 2017
The in vitro activity of pefloxacin against most Enterobacteriaceae is greater than that of amikacin, gentamicin, and ceftazidime; approximately equivalent to that of enoxacin, ofloxacin, norfloxacin, and cefotaxime, but less than the activity of ciprofloxacin (Georgopoulos et al., 1988; Gonzalez and Henwood, 1989; Gruneberg et al., 1988; Jones et al., 1986; King and Phillips, 1986; Ligtvoet and Wickerhoff-Minoggio, 1985; Phillips and King, 1988; Van Der Auwera et al., 1989; Yourassowsky et al., 1986). Pefloxacin is active against Aeromonas and Plesiomonas spp. (Gruneberg et al., 1988; Kuijper et al., 1989). Yersinia enterocolitica are generally susceptible, but ciprofloxacin has greater activity against this species (Hoogkamp-Korstanje, 1987). Campylobacter jejuni is usually sensitive, but Helicobacter pylori is moderately or poorly susceptible (Cattoir et al., 2007). Acinetobacter spp. are generally less susceptible to pefloxacin than to ciprofloxacin and ofloxacin (Joly-Guillou and Bergogne-Berezin, 1992). Gardnerella vaginalis is generally resistant (King and Phillips, 1986). Moraxella catarrhalis is susceptible (Phillips and King, 1988).
Infections of the Genital Systems
Published in Keith Struthers, Clinical Microbiology, 2017
Gardnerella vaginalis is a gram-variable facultative organism associated with bacterial vaginosis. Other organisms include Mycoplasma hominis and the anaerobe Mobiluncus. They have the ability to overwhelm the lactobacillus population of the vagina, with the resulting inflammatory response producing the discharge. Gardnerella can be detected on gram-stained preparations adherent in large numbers to vaginal epithelial cells, termed ‘clue’ cells.
Vaginitis
Published in Linda Cardozo, Staskin David, Textbook of Female Urology and Urogynecology - Two-Volume Set, 2017
once these fActors hAve been excluded or treAted, An induction regimen with An Antimycotic followed by A long-term suppressive mAintenAnce regimen is indicAted. While this cAn be Accomplished with topicAl regimens, becAuse of the durAtion And frequency of therApy, orAl therApy is more convenient And offers A more reAlistic solution. It should be emphAsized thAt the therApy selected is Aimed At controlling symptomAtic episodes rAther thAn guArAnteeing thAt cure will be Achieved. The use of long-term suppressive mAintenAnce regimens hAs been confirmed in severAl prospective controlled studies [19,20]. Accordingly, After An induction regimen of fluconAzole 150 mg given every 72 hours for 3 doses, A weekly mAintenAnce regimen of fluconAzole 150 mg once weekly is suggested. Complete resolution of symptoms follows within A mAtter of weeks, And the pAtients remAin AsymptomAtic for the durAtion of therApy, which is recommended for 6 months. During this period, the pAtient invAriAbly remAins culture negAtive And AsymptomAtic. Following discontinuAtion of therApy After 6 months, ApproximAtely 50% of the pAtients rApidly become recolonized And develop recurrent symptoms of vvC. However, 50% of pAtients will return to An AttAck-free life with risks similAr to low-risk women. should symptomAtic recurrence rApidly follow discontinuAtion of therApy, repeAt reinduction And mAintenAnce therApy is recommended this time for At leAst 12 months. Frequently, even longer prolonged mAintenAnce regimens Are recommended And required. Epidemiology bv is the most common cAuse of vAginitis in women of childbeAring Age. It hAs been diAgnosed in 17%–19% of women seeking gynecologicAl cAre in fAmily prActice or student heAlth-cAre settings [1]. The worldwide prevAlence rAnges from 11% to 48% of women of reproductive Age, with vAriAtion According to populAtion studied [21]. The prevAlence increAses considerAbly in symptomAtic women Attending stD clinics, reAching 24%–37%. bv hAs been observed in 16%–29% of pregnAnt women. GArdnerellA vAginAlis hAs been found in 10%–31% of virgin Adolescent girls but is found significAntly more frequently Among sexuAlly Active women, reAching A prevAlence of 50%–60% in some At-risk populAtions. evAluAtion of epidemiologicAl fActors hAs reveAled A few clues of the cAuse of bv. use of An intrAuterine device And douching wAs found to be more common in women with bv. bv is significAntly more common Among blAck And sexuAlly Active women including lesbiAns. PAthogenesis And PAthology bv is not due to A single orgAnism And is the result of mAssive overgrowth of mixed complex florA or microbiotA, including peptostreptococci, BActeriodes spp., G. vAginAlis, Mobiluncus spp., genitAl mycoplAsmA, And A vAriety of recently described AnAerobes [22]. There is little inflAmmAtion, And the disorder represents A disturbAnce of the vAginAl microbiAl ecosystem rAther thAn A true infection of tissues. The overgrowth of mixed florA is AssociAted with A loss of the normAl
Alteration of vaginal microbiota in patients with recurrent miscarriage
Published in Journal of Obstetrics and Gynaecology, 2022
Xuejuan Jiao, Lanling Zhang, Danli Du, Lingling Wang, Qianqian Song, Shuyu Liu
As previously reported, human vaginal microbiota play a crucial role in guarding various urogenital diseases, such as bacterial vaginosis, sexually transmitted infections and urinary tract infections (Ravel et al. 2011). Nevertheless, there are finite studies demonstrating a direct association between RM and vaginal microbiota. Vaginal microbiota species has less diversity compared with the intestinal microbiota, there were about 40 species of bacteria and facultative anaerobic in women of childbearing including Bacteroides, Gardneria, Lactobacillus, Coccidioides, Corynebacterium, Escherichia coli and Velveti (Raphael et al. 2011). Bacterial vaginosis is characterised by a complete loss of lactobacilli and a concomitant increase in Gram-variable and Gram-negative rods, primary among them Gardnerella vaginalis, as well as Bacteroides, Prevotella and Mobiluncus species. The presence of an abnormal vaginal microbiota in early pregnancy is a recognised risk factor for preterm delivery and low birth weight (Petricevic et al. 2015).
Current and emerging pharmacotherapy for recurrent bacterial vaginosis
Published in Expert Opinion on Pharmacotherapy, 2021
Already extensive studies of Gardnerella vaginalis clades have shown striking differences in virulence capacity and in vitro/susceptibility, although not yet correlated with clinical resistance. There are yet unproven benefits of high-dose vaginal metronidazole use that may be related to in vivo resistance. In vitro resistance documented by increased MICs should be separated from in vivo antimicrobial resistance. Most importantly, since the discovery of the ubiquitous vaginal biofilm incorporating G.vaginalis and numerous other potential pathogenic microorganisms, non-sessile bacteria so enclosed appear relatively inaccessible to antibiotics and independent of the reduced penetration, biofilm contained organisms are thought to experience gene initiated reduced drug sensitivity [24,61,62].
Use of copper intrauterine device is not associated with higher bacterial vaginosis prevalence in Thai HIV-positive women*
Published in AIDS Care, 2018
Nadia Kancheva Landolt, Surasith Chaithongwongwatthana, Sumanee Nilgate, Nipat Teeratakulpisarn, Sasiwimol Ubolyam, Tanakorn Apornpong, Jintanat Ananworanich, Nittaya Phanuphak
The question of what creates a healthy cervicovaginal microbiome is complex and still under research (Ravel et al., 2011). To better understand BV, and its clinical significance, there is a need to improve diagnostic methods in the clinical practice, as we found threefold difference in BV prevalence assessed by Nugent score and Amsel criteria. Our finding corraborates other reports of Amsel criteria being inferior to Nugent score in BV diagnosis (Sha et al., 2005). Quantitative bacterial PCR of certain bacteria associated with BV could improve the sensitivity and specificity of the diagnosis (Menard et al., 2010; Sha et al., 2005). It is important to apply thresholds, for improving the accuracy of the molecular methods (Datcu, 2014). Gardnerella vaginalis, for instance, can also have commensal isolates with reduced cytotoxicity, that are nearly identical to the pathogenic strain at the molecular level (Harwich et al., 2010).