nystatin-a1 and Vaginosis--Bacterial

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 compare combined vaginal administration of nystatin, diiodohydroxyquin, and benzalkonium chloride versus oral metronidazole for the treatment of bacterial vaginosis (BV).. A randomized controlled trial was conducted among women diagnosed with BV using the Amsel criteria (n=90) at a university hospital in Khon Kaen, Thailand, between June 27, 2017, and April 30, 2018. The oral metronidazole group (n=44) received 400 mg of metronidazole, administered three times per day. The combined vaginal tablet group (n=46) received a vaginal suppository once daily, which comprised nystatin (100 000 U), diiodohydroxyquin (100 mg), and benzalkonium chloride (7 mg). Treatment was administered for 7 days in both groups. Follow-up visits at 14 and 42 days assessed treatment outcomes and adverse effects.. Remission of BV occurred among 41 (93%) women in the oral metronidazole group and 39 (85%) women in the combined vaginal tablet group. The adjusted relative risk was 0.92 (95% confidence interval 0.80-1.06). The rate of nausea and/or vomiting was significantly higher in the oral metronidazole group than that in the combined vaginal tablet group.. Treatment efficacy of the combined vaginal tablet versus oral metronidazole was equivalent.. TCTR20170627001 (www.clinicaltrials.in.th).

Topics: Administration, Intravaginal; Administration, Oral; Adult; Anti-Bacterial Agents; Benzalkonium Compounds; Drug Combinations; Female; Humans; Iodoquinol; Metronidazole; Nystatin; Thailand; Treatment Outcome; Vaginal Creams, Foams, and Jellies; Vaginosis, Bacterial

The evaluation of combined and miscellaneous vulvovaginal infections incidence and their treatment with combined vaginal products containing nifuratel and nystatin.. Prospective study.. Gynecologic outpatient department LEVRET, Prague; Laboratories of Microbiology AescuLab, Prague.. 70 consecutive patients were examined with complaint of vaginal fluor and/or pruritus. We established macroscopic features of fluor, pH, amine test and mounts stained with Giemsa and Gram. We qualified the cases with more diagnostic criteria (mycosis, lactobacillosis, anaerobic vaginosis, aerobic vaginitis) as combined infection, those with no diagnostic criteria as miscellaneous. We treated all patients with vaginal tablets nystatin + nifuratel (Macmiror complex). We prescribed clotrimazol cream, if pruritus was present. We evaluated withdrawals of symptoms and relapses during 3 months after treatment.. Combined infection was found in 21 patients from 70 (30%). The most frequent combination was that of mycosis and aerobic vaginitis (13/70, 18.6%) or mycosis and anaerobic vaginosis (4/70, 5.7%); 11 patients fulfilled criteria of no diagnosis. We concluded them as "miscelaneous". The treatment was successful in all cases, 10 women relapsed in 3 months.. Combined vaginal infection findings are present very often (30%), likewise miscellaneous ones (15%) occur. The treatment of these women in successful with vaginal tablets with nystatin + nifuratel.

Topics: Administration, Intravaginal; Adult; Anti-Bacterial Agents; Antifungal Agents; Antitrichomonal Agents; Candidiasis, Vulvovaginal; Clotrimazole; Drug Combinations; Female; Humans; Middle Aged; Nifuratel; Nystatin; Trichomonas Vaginitis; Vaginosis, Bacterial; Vulvovaginitis

The objective of this study was to determine why different criteria for response to treatment of bacterial vaginosis (BV) led to markedly different conclusions about treatment efficacy in a randomized trial comparing metronidazole gel versus metronidazole/nystatin ovules.. We compared the impact of two treatment regimens on individual components of Amsel and Nugent criteria at follow-up visits 14, 42, and 104 days after initiating treatment.. Compared with gel, ovules more effectively eliminated amines, clue cells, and Gardnerella, Prevotella, or Mobiluncus morphotypes from vaginal fluid, thus achieving cure based on "usual" criteria (absence of BV by Amsel or Nugent criteria), but did not more effectively restore Lactobacillus morphotypes or lower vaginal pH, thus not meeting Federal Drug Administration (FDA) criteria for cure.. Because early vaginal recolonization by lactobacilli was poor after both gel and ovules, FDA draft criteria for cure missed marked differences in treatment efficacies against Gardnerella, clue cells, and amines. Cure defined more "usually" may give more useful information.

Topics: Adolescent; Adult; Anti-Infective Agents; Clinical Trials as Topic; Drug Therapy, Combination; Female; Gels; Humans; Metronidazole; Nystatin; Patient Selection; Treatment Outcome; Vaginosis, Bacterial

We compared metronidazole 0.75% gel (containing 37.5 mg metronidazole per dose) with ovules containing metronidazole 500 mg and nystatin 100,000 U, for intravaginal treatment of bacterial vaginosis (BV).. In a single-blinded trial, symptomatic women with BV by both Amsel and Nugent criteria were randomly assigned to gel or ovules, once nightly for 5 nights, and asked to return 3 times after treatment. Analyses were intent-to-treat.. Of 151 women with BV by both criteria at enrollment, 138 (91%) returned at least once. Product limit estimates for persistence or recurrence of BV at 14, 42, and 104 days were 20% (95% CI 10%-29%), 38% (95% CI 25%-48%), and 52% (95% CI 37%-63%) after gel treatment, and 4% (95% CI 0%-9%), 17% (95% CI 7%-26%), and 33% (95% CI 21%-46%) after ovule treatment ( P = .01). Among women without BV at first follow-up, subsequent intercourse without condoms independently predicted subsequent recurrence ( P

Topics: Administration, Intravaginal; Adolescent; Adult; Capsules; Chemistry, Pharmaceutical; Confidence Intervals; Dose-Response Relationship, Drug; Drug Administration Schedule; Drug Therapy, Combination; Female; Follow-Up Studies; Humans; Metronidazole; Nystatin; Patient Compliance; Probability; Reference Values; Risk Assessment; Severity of Illness Index; Single-Blind Method; Treatment Outcome; Vaginal Creams, Foams, and Jellies; Vaginal Smears; Vaginosis, Bacterial

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

The aim of the present multicentre study was to examine the therapeutic possibilities of the wide-spectrum medicament MACMIROR & MACMIROR COMPLEX for the treatment of the vaginal infections.. The study included 159 nonpregnant women among 15 and 54 years (middle age 35.6) with different by kind and intensity colpitis complaints. The following microbiological characteristic was established: in 26 cases Gardnerella vaginalis, in 46 Candida spp., and in the rest 87-mixed aerobic bacterial flora, with a combination of Gardnerella, yeast and Trichomonas. The treatment of the patients was done in combined scheme: peroral and vaginal administration, simultaneously with local treatment of the partner. The control examination was performed bistagely: on 7-10 day and on 30-40 day.. The good clinical and microbiological influence of the treated patients was established, for the first control examination the effect was found in 88.1% and 86.8% and for the second--respectively in 81.1% and 82.4%.. The received results give us a cause to approve, that the combination "Nifuratel and Nystatin" (Macmiror & Macmimor complex) has the good possibilities to influence the mixed forms of vaginal infection.

Topics: Adolescent; Adult; Anti-Bacterial Agents; Antifungal Agents; Antitrichomonal Agents; Candidiasis, Vulvovaginal; Drug Combinations; Female; Gardnerella vaginalis; Humans; Middle Aged; Nifuratel; Nystatin; Treatment Outcome; Trichomonas Vaginitis; Vaginosis, Bacterial

(1) To compare the effectiveness of two clinical protocols for the management of vaginal discharge in the situations where no laboratory facilities are available but speculum examination is possible and where basic laboratory facilities are available. (2) To determine clinical and simple laboratory indicators for diagnosis of patients with vaginal discharge in the local setting.. Alternate allocation of subjects to one of two management protocols.. Women presenting to university gynaecology outpatients department with a complaint of vaginal discharge.. Subjects were alternately allocated management according to one of two protocols: one without (group A) and one with (group B) immediate access to results of basic laboratory tests. Full clinical assessment including speculum examination and microbiological assessment for infection with gonorrhoea, chlamydia, candida, trichomonas, and bacterial vaginosis was performed on all women. Follow up assessment of clinical and microbiological response was performed 1-2 weeks later.. At initial assessment, both groups were similar in all respects except that more group B women had inflammation of the vulva. The prevalences of various conditions were: candidiasis 22%, bacterial vaginosis 38%, trichomoniasis 4%, chlamydia 4%, gonorrhoea 0.4%. There was no association between any demographic characteristic and diagnosis of cause of the discharge. Both protocols resulted in clinically and statistically significant improvements for women with candidiasis, bacterial vaginosis, and trichomoniasis. There were no clinically important differences in outcomes between the two protocols. The sensitivities and specificities of various indicators were: curd-like vaginal discharge for candidiasis, 72% and 100%; homogeneous vaginal discharge for bacterial vaginosis or trichomoniasis, 94% and 88%; absent or scanty lactobacilli for bacterial vaginosis, 99% and 68%; > 20% clue cells for bacterial vaginosis, 81% and 99%; visible endocervical mucopus for chlamydia or gonorrhoea, 36% and 86%; microscopic endocervical mucopus for chlamydia or gonorrhoea, 64% and 69%.. Both protocols were equally effective in managing women with abnormal vaginal discharge. Simple clinical indicators for candidiasis, bacterial vaginosis, or trichomonas as in protocol A are sufficiently sensitive and specific for use in situations with no laboratory support. A modification to protocol A could increase detection of bacterial vaginosis at basic health service level. Further work is needed to identify appropriate indicators for infection with chlamydia or gonorrhoea.

Topics: Adult; Anti-Infective Agents; Candidiasis, Vulvovaginal; Clinical Protocols; Doxycycline; Female; Gonorrhea; Humans; Leukorrhea; Metronidazole; Microbiological Techniques; Middle Aged; Nystatin; Ofloxacin; Physical Examination; Trichomonas Vaginitis; Uterine Cervicitis; Vaginosis, Bacterial

In a double-blind trial comprising 66 patients we assessed the effect of metronidazole-nystatin vagitories on the prevention of bacterial vaginosis (BV) in women using IUD as a contraceptive method after an initial oral single dose of 2.0 g metronidazole and 7 days of intravaginal metronidazole-nystatin or placebo treatment. The prophylactic treatment consisted of metronidazole-nystatin or placebo vagitories applied at bedtime for 3 days after menstruation over 6 consecutive menstrual periods. The patients were randomized in two study groups: a treatment group of 32 patients (group A) and a placebo group of 34 patients (group B). The overall objective cure rate after the initial treatment was 97% in group A and 91% in group B. After 6 months of follow-up, the overall cumulative objective cure rate in group A was 100%, and 76% in group B. The single-dose oral treatment was well tolerated and no notable side effects were recorded.

Topics: Administration, Intravaginal; Administration, Oral; Adult; Double-Blind Method; Drug Combinations; Female; Humans; Intrauterine Devices; Metronidazole; Nystatin; Treatment Outcome; Vaginosis, Bacterial

This open clinical trial in 121 patients carried out by gynaecologists shows the difficulty in establishing the clinical diagnosis of vaginal candidosis or vaginal infectious candidosis. On the other hand, specific vaginitis can easily be identified, without carrying out vaginal smear. Bacteriological and clinical arguments show the efficacy of using an antibiotic association by the vaginal route for the treatment of these types of vaginitis (candidosis or infectious candidosis). The product is particularly interesting in all cases where vaginal smear have not been taken.

Topics: Adolescent; Adult; Antitrichomonal Agents; Arsenicals; Candidiasis, Vulvovaginal; Drug Combinations; Female; Gynecology; Humans; Middle Aged; Neomycin; Nystatin; Polymyxins; Vaginosis, Bacterial

Vaginal infections /VI/ represent some of the most common diseases by infection of FGS. The aim of this study is to analyze clinical and bacteriological efficacy of Polygynax in the treatment of vaginal infections and to take into account the correlation between the results of microbiological controls and reduction of clinical symptoms. The study included 100 patients, including 50 pregnant and non-pregnant 50 for a period of 3 months. All of them was diagnosed with vaginitis clinical examination, taken material from vagina for microbiological testing. The studied women was conducted targeted therapy Polygynax 12 capsules, in the form of vaginal capsules for 12 days, after which the sample control microbiology. Behind the subjective complaints of the patient and to reduce them as a result of treatment. The effective implementation of Polygynax 12 capsules is equally good as in non-pregnant and pregnant women. In a summary of the survey data to make relevant analyzes and conclusions from the results.

Topics: Adult; Anti-Bacterial Agents; Arsenicals; Drug Combinations; Female; Humans; Neomycin; Nystatin; Polymyxins; Pregnancy; Pregnancy Complications, Infectious; Vagina; Vaginosis, Bacterial

Topics: Anti-Bacterial Agents; Clindamycin; Congresses as Topic; Drug Therapy, Combination; Female; HIV Infections; Humans; Infectious Disease Transmission, Vertical; Metronidazole; Microscopy; Nystatin; Periodontitis; Pregnancy; Pregnancy Complications, Infectious; Risk Factors; Sulfamethazine; Sulfonamides; Time Factors; Vaginosis, Bacterial

Polygynax is a product commercialized in the form of vaginal capsule, associating bactericidal antibiotics: Neomycin, Polymyxin B and Nystatin--an antifungal agent which is fungicidal and fungistatic in vitro and in vivo.. The objectives of the study were to analyze the clinical and bacteriological efficacy of Polygynax in the treatment of bacterial vaginitis with one or more germs (mixed vaginitis) and Candida infections, and to investigate the correlation between the results of the initial clinical examination and bacteriological studies.. The study covered 88 patients diagnosed with mixed vaginitis during initial screening of vaginal flora (direct Gram stains and standard microbiology laboratory methods for cultivation of vagina/ cervix smears with antibiotic susceptibility testing). The patients were treated with Polygynax, applied in form of vaginal capsules (during 12 days, application before retiring). After at least 30 days following last day of therapy, the same diagnostic swabs were repeated. In this period, averaging 38.4 days, sexual abstinence was recommended.. The results showed that total clearance of present germs was found in 83/88 patients (94.3% of the cases), according to the repeated cervico- vaginal smears.. Polygynax is a treatment of preference against fungal infections, with added advantage of having wide antibacterial spectrum.

Topics: Arsenicals; Candidiasis, Vulvovaginal; Drug Combinations; Female; Humans; Neomycin; Nystatin; Polymyxins; Treatment Outcome; Vaginal Smears; Vaginosis, Bacterial

Comparative, in vivo, human, prospective, single blind, clinical and microbiological diagnoses based and randomised study of the treatment of uncomplicated bacterial vaginosis with two forms of combined (metronidazole + nystatin + sulfadimidin) vaginal suppositories (laminated and mixed containing the same ingredients) and the standard preparations available in the Hungarian market (Dalacin vaginal cream and Klion vaginal suppository). The examinations involved 60 volunteers and were performed in the Gynecological Outpatient Clinic of the Council of Erd, the microbiological samples were examined at Saint Rókus Hospital in Budapest. The combined treatment was better tolerated and resulted in normal vaginal pH significantly more often at the same rate of recovery. The combined treatment is simultaneously effective in cases of the most prevalent coinfections too.

Topics: Administration, Intravaginal; Adolescent; Adult; Aged; Anti-Bacterial Agents; Anti-Infective Agents; Drug Therapy, Combination; Female; Humans; Hydrogen-Ion Concentration; Metronidazole; Middle Aged; Nystatin; Sulfamethazine; Treatment Outcome; Vaginosis, Bacterial

Topics: Antifungal Agents; Arsenicals; Bacterial Infections; Candidiasis, Vulvovaginal; Drug Combinations; Female; Humans; Neomycin; Nystatin; Polymyxins; Vaginal Creams, Foams, and Jellies; Vaginosis, Bacterial

The aim of the present study was to examine the therapeutic possibilities of the wide-spectrum medicament Macmiror & Macmiror Complex for the treatment of the vaginal infections.. The study included 52 nonpregnant women among 20 u 54 years (middle age 30.5) with different by kind and intensity colpitis complains. The following microbiological characteristic was established: in 26 cases Candida spp., in 19 Gardnerella vaginalis, in 1 Trichomonas vaginalis and in the rest 6 mixed infection. The treatment of the patients was done in combined scheme: peroral and vaginal administration simultaneously with local treatment of the partner. The control examination was performed bistagely: on 7-10 day and on 30-40 day.. The good clinical and microbiological influence of the treated patients was established for the first control examination the effect was found in 89.5% u 84.2% go of the cases with bacterial vaginosis and in 84.6% u 69.2% in those with mycotic colpitis. Relatively high values were found also at the second control, respectively 83.3% and 72.2% for the amine colpitis and 69.5% and 52.2% for vaginal candidosis. The similar favorable influence received also in the rest of the patients.. Our results do show good possibilities of the nifuratel and nystatin combination (Macmiror & Macmiror complex) to influence vaginitis with different etiology, which give us founding to consider, that the drug is suitable for the mixed forms of vaginal infection.

Topics: Adult; Anti-Bacterial Agents; Antifungal Agents; Antitrichomonal Agents; Candidiasis, Vulvovaginal; Drug Combinations; Drug Evaluation; Female; Gardnerella vaginalis; Humans; Middle Aged; Nifuratel; Nystatin; Trichomonas Vaginitis; Vaginosis, Bacterial

To report a case of a possible hypersensitivity reaction induced by metronidazole.. An Asian woman with a history of recurrent vaginitis had previously developed localized erythema while on intravaginal metronidazole and nystatin. While receiving oral metronidazole for treatment of a current bacterial vaginosis, she developed chills, fever, generalized erythema, and a rash within 60 minutes of the first dose. Treatment with diphenhydramine was instituted. The following day while in the hospital, the patient's condition worsened; she experienced shortness of breath and increased edema of the extremities. Methylprednisolone was administered with diphenhydramine and her condition improved over the next 5 days. The patient's vaginitis was treated with gentian violet and she was discharged on a tapering dosage of prednisone.. Metronidazole-induced cutaneous reactions and systemic hypersensitivity reactions are reviewed. Alternatives to metronidazole and other potential cross-reactive drugs are suggested for the treatment of recurrent vaginitis.. Although the patient's initial reaction to metronidazole represented a rare event, written documentation and communication in the patient's native language may have prevented the subsequent severe hypersensitivity reaction.

Topics: Adult; Biological Availability; Candidiasis, Vulvovaginal; Drug Hypersensitivity; Drug Therapy, Combination; Female; Humans; Metronidazole; Nystatin; Recurrence; Vaginosis, Bacterial