zithromax and Vulvovaginitis

To evaluate the effectiveness and safety of local vs systemic antibiotic treatment in the management of recurrent vulvovaginitis in children.. Randomized treatment and follow-up of 90 cases of persistent vulvovaginitis.. The Department of Medicine and Health Sciences, Institute of Gynecology and Obstetrics, University of Molise, Italy.. Between January 2009 and December 2012, 90 prepubertal girls (Tanner Stage I) aged 6-12 years, with recurrent discharge not responding to common hygienic measures and not suspected of being sexually abused, were treated, 45 patients with oral antibiotic treatment (group 1) and 45 patients with a local antibiotic treatment (group 2). Vaginal cultures were prepared before treatment and follow-ups were made after 3 months.. Bacterial pathogens were isolated in vaginal secretions of 84/90 (93%) girls. There were 6 girls receiving antibiotic treatment who had persistent discharge and repetitive isolations of Escherichia coli. Administration type was selected at random. Symptoms and signs were resolved in all girls, but we observed 1 recurrence (2.22%) in group 2 vs 6 recurrences (13.33%) in group 1 (P = .049). In group 1 we observed 3 cases (6.67%) of gastro-intestinal side effects vs no cases in group 2 (P = .079).. Topical medication based on netilmicin, associated with Benzalkonium-Chloride, showed a clinical and microbiological effectiveness in first-line treatment of bacterial vulvovaginitis in children, comparable to conventional drugs; so local treatment may be a good alternative to systemic treatment decreasing the use of oral antibiotics in young people and related risks of bacterial resistances.

Topics: Administration, Oral; Administration, Topical; Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Azithromycin; Cefixime; Child; Female; Humans; Netilmicin; Recurrence; Vulvovaginitis

Test of cure (TOC) for. The Sexually Transmitted Bacteria Reference Unit at Public Health England undertook testing of gonococcal and chlamydial nucleic acids within neat urine stored in different conditions over 25 days to provide evidence of the stability of the nucleic acid prior to recruitment. Individuals diagnosed with uncomplicated NG or CT infection were recruited from three sexual health clinics. Individuals were asked to return nine self-taken samples from the site of infection over a course of 35 days. Survival analyses of time to first negative NAAT result for NG and CT infection and univariate regression analysis of factors that affect time to clearance were undertaken.. At room temperature, chlamydial DNA in urine is stable for up to 3 weeks and gonococcal DNA for up to 11 days. We analysed data for 147 infections (81 NG and 66 CT). The median time to clearance of infection was 4 days (IQR 2-10 days) for NG infection and 10 days (IQR 7-14 days) for CT infection. Vaginal CT infections took longer to clear (p=0.031). NG infection in men who have sex with men took longer to clear (p=0.052).. Chlamydial and gonococcal nucleic acids are stable in urine before addition of preservatives, longer than recommended by the manufacturer. The TOC results suggest that it may be possible to undertake TOC for NG and CT infections earlier than current guidelines suggest and that anatomical site of infection may affect time to clearance of infection.

Topics: Adult; Aged; Anti-Bacterial Agents; Azithromycin; Ceftriaxone; Chlamydia Infections; Chlamydia trachomatis; Doxycycline; Feasibility Studies; Female; Gonorrhea; Humans; Male; Middle Aged; Neisseria gonorrhoeae; Nucleic Acid Amplification Techniques; Pharyngitis; Proctitis; Real-Time Polymerase Chain Reaction; Time Factors; Treatment Outcome; Urethritis; Vulvovaginitis; Young Adult