nystatin-a1 and Vaginitis

Vaginally applied antimicrobial agents are widely used in the vagina in women with lower genital tract infections. An 'antimicrobial' is a general term that refers to a group of drugs that are effective against bacteria, fungi, viruses and protozoa. Topical treatments can be prescribed for a wide variety of vaginal infections. Many bacterial infections, such as bacterial vaginosis, desquamative inflammatory vaginitis or, as some European authors call it, aerobic vaginitis as well as infection with Staphylococcus aureus or group A streptococci, may be treated in this way. Candida vulvovaginitis is a fungal infection that is very amenable to topical treatment. The most common viral infections which can be treated with topical medications are condylomata acuminata and herpes simplex. The most often encountered protozoal vaginitis, which is caused by Trichomonas vaginalis, may be susceptible to topical medications, although this infection is treated systemically. This chapter covers the wide variety of commonly used topical antimicrobial agents for these diseases and focuses on the individual therapeutic agents and their clinical efficacy. In addition, potential difficulties that can occur in practice, as well as the usage of these medications in the special setting of pregnancy, are described in this chapter.

Topics: Administration, Intravaginal; Aminoquinolines; Anti-Infective Agents, Local; Antifungal Agents; Antiviral Agents; Azoles; Clindamycin; Dequalinium; Female; Hexetidine; Humans; Imiquimod; Metronidazole; Nystatin; Podophyllotoxin; Pregnancy; Pregnancy Complications, Infectious; Trichloroacetic Acid; Vaginitis

Topics: Antifungal Agents; Bacterial Infections; Candidiasis, Vulvovaginal; Clotrimazole; Drug Administration Schedule; Female; Humans; Metronidazole; Miconazole; Nystatin; Trichomonas Vaginitis; Vaginitis

Infectious vaginitis occurs when the normal vaginal flora is disrupted; it may arise when saprophytes overwhelm the host immune response, when pathogenic organisms are introduced into the vagina or when changes in substrate allow an imbalance of microorganisms to develop. Examples of these types of vaginitis include the presence of chronic fungal infection in women with an inadequate cellular immune response to the yeast, the introduction of trichomonads into vaginal epithelium that has a sufficient supply of glycogen, and the alteration in bacterial flora, normally dominated by Lactobacillus spp., and its metabolites that is characteristic of "nonspecific vaginitis". The authors review microbiologic and clinical aspects of the fungal, protozoal and bacterial infections, including the interactions of bacteria thought to produce nonspecific vaginitis, that are now recognized as causing vaginitis. Other causes of vaginitis are also discussed.

Topics: Antibody Formation; Antifungal Agents; Candidiasis; Candidiasis, Vulvovaginal; Carrier State; Female; Gardnerella vaginalis; Haemophilus Infections; Humans; Lactobacillus; Male; Metronidazole; Mycoplasma Infections; Nystatin; Pregnancy; Pregnancy Complications, Infectious; Sexual Behavior; Streptococcal Infections; Streptococcus agalactiae; Trichomonas Vaginitis; Vagina; Vaginitis; Virus Diseases

Topics: Adult; Candidiasis; Clinical Laboratory Techniques; Diagnosis, Differential; Female; Haemophilus Infections; Humans; Metronidazole; Nystatin; Recurrence; Sulfonamides; Trichomonas Vaginitis; Vaginal Diseases; Vaginitis; Vulvovaginitis

An empirical treatment of infectious vaginitis is justified because of its multiple etiologies, the frequent uncertainty of clinical diagnosis and limits of microbiological analysis. Our aim was to comparatively investigate nystatin-neomycin-polymyxin B combination (NNP, Polygynax. In this European multicenter, double-blind PRISM trial, participating women presenting with infectious vaginitis were randomized to receive one vaginal capsule containing either NNP for 12 days or miconazole for 3 days followed by 9 days of placebo.. The clinical success rate was higher in the NNP group (n=302) than the miconazole group (n=309), with a difference between groups close to statistical significance (91.1% vs. 86.7%, P=0.0906). The risk of treatment failure was 36% lower in the NNP group (odds ratio, 0.64; 95% confidence interval, 0.38-1.07). Vaginal burning on Day 2 and vaginal discharge on Day 4 were significantly less intense in the NNP group than in the miconazole group (39.1 vs. 42.3, P=0.031 and 34.6 vs. 37.6, P=0.031, respectively). Adverse drug reactions were reported by 1.2% and 2.1% of patients in the NNP and miconazole group respectively, with the ratio of adverse drug reactions relative to total adverse events significantly higher in the miconazole group (20.3% vs. 6.9%, P=0.022).. The widespread use of NNP for several decades and its good efficacy and safety profile, as well as the frequent diagnostic uncertainties due to the various pathogens sustain the initiation of this broad-spectrum empirical treatment in infectious vaginitis.

Topics: Adolescent; Adult; Arsenicals; Candidiasis, Vulvovaginal; Double-Blind Method; Drug Combinations; Drug Therapy, Combination; Female; Humans; Miconazole; Middle Aged; Neomycin; Nystatin; Polymyxins; Treatment Outcome; Vaginitis; Vaginosis, Bacterial; Young Adult

To assess the effect of treatment of vaginal infections on vaginal shedding of cell-free human immunodeficiency virus type 1 (HIV-1) and HIV-1-infected cells, HIV-1-seropositive women were examined before and after treatment of Candida vulvovaginitis, Trichomonas vaginitis, and bacterial vaginosis. For Candida (n=98), vaginal HIV-1 RNA decreased from 3.36 to 2.86 log(10) copies/swab (P<.001), as did the prevalence of HIV-1 DNA (36% to 17%; odds ratio [OR], 2.8; 95% confidence interval [CI], 1.3-6.5). For Trichomonas vaginitis (n=55), HIV-1 RNA decreased from 3.67 to 3.05 log(10) copies/swab (P<.001), but the prevalence of HIV-1 DNA remained unchanged (22%-25%; OR, 0.8; 95% CI, 0.3-2.2). For bacterial vaginosis (n=73), neither the shedding of HIV-1 RNA (from 3.11 to 2.90 log(10) copies/swab; P=.14) nor the prevalence of DNA (from 21% to 23%; OR, 0.8; 95% CI, 0.3-2.0) changed. Vaginal HIV-1 decreased 3.2- and 4.2-fold after treating Candida and Trichomonas, respectively. These data suggest that HIV-1 transmission intervention strategies that incorporate diagnosis and treatment of these prevalent infections warrant evaluation.

Topics: Adult; Anti-Bacterial Agents; Antitrichomonal Agents; Candidiasis; DNA, Viral; Down-Regulation; Female; HIV Infections; HIV Seropositivity; HIV-1; Humans; Metronidazole; Nystatin; Odds Ratio; Prospective Studies; RNA, Viral; Trichomonas Vaginitis; Vagina; Vaginitis; Vaginosis, Bacterial; Virus Shedding

Evaluation of oral treatment in vaginitis and vaginosis using Itraconazol and sechidazol, in comparison to topic treatment using vaginal ovules of acetonido of fluocinolona 0.50 mg, nistatina 100,000 U and metronidazol 500 mg.. Longitudinal, prospective and open comparative study.. Servicio de Reproducción Humana(Human Reproduction Department), Centro Médico Nacional "20 de Noviembre".. Forty female patients, without any relevant differences in their general characteristics, chose diagnosis was vaginitis and vaginosis, who were medically treated through external consultation, divided in two groups of twenty each one. Group 1 oral treatment with itraconazol and secnidazol. Group 2 had topic treatment with fluocinolona, nistatina and metronidazol. All of the patients were controlled in seven and fourteen days time, in order to evaluate the intensity of their clinical symptomatology, as well as the efficacy in both ways of treatment.. Leukorrhea was the most important symptom in all the cases, going from minor to serious white discharge. After the treatment, we found a relevant difference statistically significative in patients treated with intraconazol and secnidazol. We did not find any differences in relation to ardor, pruritus, dispareunia and disuria at post-treatment evaluation. However, group 1 betterment was statistically significative between the first and the seventh days of treatment.. Treating vaginitis or vaginosis (or both) with itraconazol and secnidazol takes less time for betterment in addition to comfort and easiness of oral administration; therefore, we consider them proper medicines in these specific cases.

Topics: Antiprotozoal Agents; Antitrichomonal Agents; Female; Fluocinolone Acetonide; Humans; Itraconazole; Metronidazole; Nystatin; Vaginitis

Topics: Adult; Clinical Trials as Topic; Female; Humans; Miconazole; Middle Aged; Mycoses; Nystatin; Random Allocation; Vaginitis

The relationship between vaginal pH, microflora, and yeast infection was investigated in 93 women randomly treated with either nystatin or miconazole pessaries and cream for two weeks. The vaginal pH was measured in a control group of 48 women. In the study group, 37 patients defaulted, 39 were cured, and 17 required treatment during the six-month follow-up period. In both study and control groups before and after treatment the mean vaginal pH was in the range of 4.3-4.6. Lactobacilli were plentiful in 78 (91%) out of 86 patients and shows that lactobacilli and yeasts commonly coexist. The influence of other organisms appeared to be negligible. The trial showed that nystatin and micromazole were equallly effective in the treatment of vaginal yeast infection and that the broad-spectrum activity of micronazole offered no advantage in this condition.

Topics: Adolescent; Adult; Female; Humans; Hydrogen-Ion Concentration; Lactobacillus; Menstruation; Miconazole; Middle Aged; Mycoses; Nystatin; Vagina; Vaginitis; Yeasts

Topics: Candidiasis, Vulvovaginal; Clinical Trials as Topic; Drug Therapy, Combination; Female; Humans; Metronidazole; Nifuratel; Nitrofurans; Nystatin; Trichomonas Vaginitis; Vaginitis

Topics: Antifungal Agents; Clinical Trials as Topic; Female; Humans; Hydrogen-Ion Concentration; Metronidazole; Mycoses; Natamycin; Nystatin; Trichomonas Vaginitis; Vaginitis

To develop more effective antifungal microparticulate therapeutic systems for the treatment of Candida vaginitis, microparticles containing nystatin were elaborated by emulsification/internal gelation method. Three types of microparticles were successfully prepared, alginate microparticles, chitosan and poloxamer 407 coated alginate microparticles. DSC and FT-IR studies were performed to test the efficacy of the method. After physicochemical characterization, mean particle sizes ranged from 36.088 μm to 56.146 μm. The encapsulation efficiency was found to be similar for alginate and chitosan coated microparticles and lower for poloxamer 407 coated. Optimal mucoadhesive properties in all kind of microparticles where exhibited. Release studies showed the best kinetic parameters for poloxamer 407 coated microparticles. After ex vivo permeation studies through porcine vaginal mucosa, and determination of the amount of nystatin retained as well as microbiologic studies performed, it could be inferred that the developed microparticulate systems offered an antifungal effect against Candida albicans without toxic systemic absorption.

Topics: Absorption; Administration, Intravaginal; Alginates; Animals; Antifungal Agents; Calorimetry, Differential Scanning; Candida albicans; Candidiasis; Capsules; Chitosan; Coated Materials, Biocompatible; Drug Carriers; Female; Glucuronic Acid; Hexuronic Acids; Humans; Microbial Sensitivity Tests; Mucous Membrane; Nystatin; Particle Size; Poloxamer; Spectroscopy, Fourier Transform Infrared; Surface Properties; Sus scrofa; Vaginitis

A test included 40 women in the reproductive age with clinical symptoms of vaginitis and microbiological examination. They were treated by combined therapy of vaginal tablets of nifuratel, 500 mg and nistatin 200 000 i. u. during six days, after which they underwent gynaecological reexamination and repeated microbiological examination of vaginal and cervical smears. An analiysis of vaginal secretion found bacterial flora in 34 smears (65%), fungus (Candida albicans) in 15 (24%) and Trichomonas vaginalis in 7 (11%). Local vaginal therapy in vaginitis caused by Trichomonas vaginalis was successfull in all 7 patients, vaginitis caused by Candida albicans was successly treated in 14 (93%) patients. Bacterial vaginitis was cured in 29 (71%) patients during this tharapy. Local vaginal combined therapy of nifuratel and nistatin is eficient in patients with vaginitis caused by fungi and Trichomonas vaginalis too.

Topics: Adult; Anti-Bacterial Agents; Antifungal Agents; Drug Combinations; Female; Humans; Nifuratel; Nystatin; Vaginal Creams, Foams, and Jellies; Vaginitis; Young Adult

Topics: Adult; Anti-Bacterial Agents; Anti-Infective Agents, Local; Arsenicals; Benzalkonium Compounds; Drug Combinations; Female; Humans; Neomycin; Nystatin; Polymyxins; Vagina; Vaginitis; Young Adult

Topics: Anti-Infective Agents; Drug Administration Schedule; Drug Combinations; Female; Humans; Male; Nifuratel; Nystatin; Sexually Transmitted Diseases; Urologic Diseases; Vaginitis

Topics: Chlamydia Infections; Costs and Cost Analysis; Female; Humans; Nystatin; Tetracycline; Vaginitis

Genital candidosis is extremely common and its incidence appears to be rising. The epidemiology, clinical features, predisposing factors and treatment of the condition are reviewed.

Topics: Candidiasis, Vulvovaginal; Coitus; Diabetes Complications; England; Epidemiologic Methods; Female; Humans; Ketoconazole; Male; Nystatin; Penis; Time Factors; Vagina; Vaginitis; Vulvitis

Vaginitis is one of the most common complaints of women in the United States today. About 90% of patients with this problem suffer from infection of the vagina caused by Candida, Gardnerella, or Trichomonas. The diagnosis and effective treatment of these common infections depend on accurate identification of the entity, effective specific therapy, and restoration of the normal ecosystem of the vagina. At the same time women should be made aware that not all discharge means infection and that any attempts at self-treatment may only worsen their condition. Proper hygiene habits, dietary control, and management of stress are all helpful factors in the control of recurrent vaginal infections.

Topics: Anti-Bacterial Agents; Candidiasis, Vulvovaginal; Female; Gardnerella vaginalis; Haemophilus Infections; Humans; Lactams; Male; Metronidazole; Nystatin; Recurrence; Sexual Behavior; Trichomonas Vaginitis; Vaginal Smears; Vaginitis

Topics: Adult; Anti-Bacterial Agents; Bacterial Infections; Candidiasis, Vulvovaginal; Female; Humans; Nifuratel; Nystatin; Trichomonas Vaginitis; Uterine Cervicitis; Vaginitis

Topics: Adult; Candidiasis, Vulvovaginal; Drug Combinations; Female; Humans; Middle Aged; Nifuratel; Nitrofurans; Nystatin; Trichomonas Vaginitis; Uterine Cervicitis; Vaginitis

Topics: Bacterial Infections; Candidiasis, Vulvovaginal; Female; Humans; Metronidazole; Miconazole; Nystatin; Recurrence; Trichomonas Vaginitis; Vaginitis

Topics: Antifungal Agents; Bacteria; Candida; Candida albicans; Candidiasis, Vulvovaginal; Clotrimazole; Female; Humans; Imidazoles; Miconazole; Mycoses; Nystatin; Vagina; Vaginitis

Therapeutic failure in vaginitis can be minimized if all cases are properly diagnosed and specific therapy is given. Use of wet mounts combined with liberal use of cultures, especially for Corynebacterium vaginale, should result in an accurate diagnosis in over 90% of cases. Treatment of choice for candidiasis is nystatin or miconazole nitrate applied topically. For trichomoniasis, metronidazole should be given orally to both sexual partners. Ampicillin, cephalexin, or cephradine are recommended for C vaginale infection.

Topics: Ampicillin; Candidiasis, Vulvovaginal; Contraception; Corynebacterium Infections; Female; Humans; Metronidazole; Miconazole; Mycoses; Nystatin; Sexual Behavior; Trichomonas Vaginitis; Vaginitis

Topics: Drug Combinations; Drug Tolerance; Female; Metronidazole; Nystatin; Vagina; Vaginal Creams, Foams, and Jellies; Vaginitis

Topics: Adult; Antitrichomonal Agents; Diabetes Complications; Drug Combinations; Female; Humans; Leukorrhea; Middle Aged; Nystatin; Pharmaceutical Vehicles; Vaginitis

Topics: Adolescent; Candida albicans; Candidiasis, Vulvovaginal; Child; Corynebacterium Infections; Female; Gonorrhea; Haemophilus Infections; Herpes Simplex; Humans; Hydrogen-Ion Concentration; Metronidazole; Mycoplasma Infections; Nystatin; Pregnancy; Pregnancy Complications, Infectious; Trichomonas Vaginitis; Tuberculosis, Urogenital; Vagina; Vaginitis

Topics: Administration, Oral; Administration, Topical; Amphotericin B; Animals; Antifungal Agents; Candida; Candida albicans; Candidiasis; Cricetinae; Drug Evaluation, Preclinical; Female; Guinea Pigs; Hexachlorophene; Mice; Natamycin; Nystatin; Rats; Tetracycline; Trichomonas Infections; Trichomonas vaginalis; Trichomonas Vaginitis; Vaginitis

Topics: Candidiasis, Vulvovaginal; Contraceptives, Oral; Female; Humans; Nystatin; Vaginitis

A guest faculty discussed the management of patients with vaginal infections. It was agreed that correct diagnosis is necessary before therapy. Diagnosis can be accomplished by a microscopic examination in 90% of the cases. The cytologic smear is also very important. Specific culture media may be useful for troublesome cases, for instance, blood agar fo Haemophilus vaginalis, Trichocel medium for Trichiomonas vaginalis, Neckerson's medium for candidal species and Thayer-Martin for Neisseria gonorrhoeae. Patient history is important since some infections tend to occur in certain patients such as candidiasis in patients with diabetes mellitus, patients who are pregnant or are taking broad spectrum antibiotics, estrogen or contraceptive pills. The pH of vaginal secretions may also be helpful in making the diagnosis. It was suggested that the term "nonspecific" vaginitis is a misnomer and is used to conceal ignorance. Others felt that such agents as soap, vaginal deodorant spray, and clothing may be causatives. The term "psychogenic leukorrhea" was discussed with varying conclusions. Routine treatment for each form of vaginitis was outlines and treatment for recurrent, persistent trichomoniasis and moniliasis was given. It was agreed that douching will not cure vaginitis but may be useful in removing excessive secretion. It is not recommended for routine hygeine but is acceptable following menstruation or intercourse.

Topics: Adult; Candidiasis, Vulvovaginal; Child; Chronic Disease; Clioquinol; Estrogens, Conjugated (USP); Female; Haemophilus Infections; Humans; Leukorrhea; Metronidazole; Nitrofurazone; Nystatin; Pregnancy; Sulfates; Therapeutic Irrigation; Trichomonas Vaginitis; Vagina; Vaginal Smears; Vaginitis

Topics: Age Factors; Candidiasis; Child; Female; Humans; Nystatin; Vaginitis

Topics: Adolescent; Adult; Candida; Female; Haemophilus; Humans; Metronidazole; Nystatin; Trichomonas; Vaginitis

Topics: Adult; Estrogens; Female; Humans; Metronidazole; Middle Aged; Nystatin; Urination Disorders; Uterine Cervicitis; Vaginitis

Topics: Female; Humans; Mycoses; Nystatin; Pregnancy; Pregnancy Complications, Infectious; Vaginitis

Topics: Adolescent; Adult; Female; Humans; Imidazoles; Leukorrhea; Male; Nystatin; Oxytetracycline; Vaginitis

Topics: Adolescent; Candidiasis, Vulvovaginal; Child; Diabetes Mellitus; Drug Therapy; Female; Gonorrhea; Humans; Infant; Infant, Newborn; Metronidazole; Nystatin; Pregnancy; Trichomonas Vaginitis; Uterine Cervicitis; Vaginitis; Varicose Veins; Vulvar Neoplasms; Vulvitis; Vulvovaginitis

Topics: Candidiasis; Candidiasis, Vulvovaginal; Female; Humans; Nystatin; Organic Chemicals; Vaginitis; Vulvovaginitis

Topics: Candida; Candidiasis, Vulvovaginal; Female; Humans; Nystatin; Vaginitis; Vulvovaginitis

Topics: Anti-Bacterial Agents; Antibiotics, Antitubercular; Candidiasis; Candidiasis, Vulvovaginal; Female; Humans; Intraabdominal Infections; Nystatin; Vaginitis

Topics: Anti-Bacterial Agents; Antibiotics, Antitubercular; Candidiasis; Candidiasis, Vulvovaginal; Female; Humans; Intraabdominal Infections; Nystatin; Vaginitis

Topics: Anti-Bacterial Agents; Antibiotics, Antitubercular; Candidiasis; Candidiasis, Vulvovaginal; Female; Humans; Intraabdominal Infections; Nystatin; Vaginitis; Vulvovaginitis

Topics: Anti-Bacterial Agents; Candidiasis; Candidiasis, Vulvovaginal; Female; Humans; Nystatin; Vaginitis; Vulvitis; Vulvovaginitis

Topics: Anti-Bacterial Agents; Antibiotics, Antitubercular; Candidiasis; Disease; Female; Humans; Nystatin; Vagina; Vaginal Diseases; Vaginitis; Vulva; Vulvar Diseases

Topics: Anti-Bacterial Agents; Candida; Female; Humans; In Vitro Techniques; Nystatin; Organic Chemicals; Vaginitis; Yeasts

Topics: Anti-Bacterial Agents; Candidiasis; Dermatologic Agents; Female; Humans; Nystatin; Vaginitis

Topics: Anti-Bacterial Agents; Candida; Candida albicans; Candidiasis; Disease; Female; Humans; Incidence; Nystatin; Vagina; Vaginal Diseases; Vaginitis; Vulva; Vulvar Diseases