Abstract
The purpose of this study was to investigate the therapeutic efficacy of oral moxifloxacin for aerobic vaginitis (AV). We also identified factors that are associated with therapeutic efficacy. This prospective study enrolled general gynecological outpatients at Tianjin Medical University General Hospital between September 2012 and May 2014. Women diagnosed with AV (n = 102) were recruited. All enrolled women were treated with oral moxifloxacin, 400 mg once daily for 6 days (one course). Therapeutic efficacy was evaluated based on microscopic criteria, and cure rates were calculated. Women who were microscopically improved (but not cured) received a second course of therapy. Women classified with microscopic failure were treated using other strategies. Univariate and multivariate logistic regression analysis was used to identify factors that may be associated with a cure after one course of therapy. After one course of therapy, 65.7 % (67/102) of women were cured, 29.4 % (30/102) of women were improved (but not cured), 4.9 % (5/102) of women failed to respond to the therapy. After two courses of therapy, 85.3 % (87/102) of women were cured, 9.8 % (10/102) of women were improved, 4.9 % (5/102) of women failed to respond to the therapy, and clinical improvement was achieved in additional women. In the multivariate logistic regression analysis, women with a baseline vaginal pH value of <5.0 had a 3.5-times higher chance of being cured, compared with those with a baseline vaginal pH value of ≥5.0 (OR, 3.503; 95 % CI, 1.278–9.601). Moxifloxacin is an effective therapeutic option for patients with AV. Most women with AV were cured with one course of moxifloxacin. For those with a higher vaginal pH value of ≥5.0 before treatment, two courses of therapy should be considered.
Similar content being viewed by others
References
Donders GG, Vereecken A, Bosmans E, Dekeersmaecker A, Salembier G, Spitz B (2002) Definition of a type of abnormal vaginal flora that is distinct from bacterial vaginosis: aerobic vaginitis. BJOG 109(1):34–43
Tansarli GS, Kostaras EK, Athanasiou S, Falagas ME (2013) Prevalence and treatment of aerobic vaginitis among non-pregnant women: evaluation of the evidence for an underestimated clinical entity. Eur J Clin Microbiol Infect Dis 32(8):977–984
Donders G, De Wet HG, Hooft P, Desmyter J (1993) Lactobacilli in Papanicolaou smears, genital infections, and pregnancy. Am J Perinatol 10(5):358–361
Marconi C, Donders GG, Martin LF, Ramos BR, Duarte MT, Parada CM, Tristão AR, Silva MG (2012) Chlamydial infection in a high risk population: association with vaginal flora patterns. Arch Gynecol Obstet 285(4):1013–1018
Donders G, Bellen G, Rezeberga D (2011) Aerobic vaginitis in pregnancy. BJOG 118(10):1163–1170
Tempera G, Abbadessa G, Bonfiglio G, Cammarata E, Cianci A, Corsello S, Raimondi A, Ettore G, Nicolosi D, Furneri PM (2006) Topical kanamycin: an effective therapeutic option in aerobic vaginitis. J Chemother 18(4):409–414
Sobel JD (1994) Desquamative inflammatory vaginitis: a new subgroup of purulent vaginitis responsive to topical 2% clindamycin therapy. Am J Obstet Gynecol 171(5):1215–1220
Fan A, Yue Y, Geng N, Zhang H, Wang Y, Xue F (2013) Aerobic vaginitis and mixed infections: comparison of clinical and laboratory findings. Arch Gynecol Obstet 287(2):329–335
Nugent RP, Krohn MA, Hillier SL (1991) Reliability of diagnosing bacterial vaginosis is improved by a standardized method of gram stain interpretation. J Clin Microbiol 29(2):297–301
Aroutcheva A, Gariti D, Simon M, Shott S, Faro J, Simoes JA, Gurguis A, Faro S (2001) Defense factors of vaginal lactobacilli. Am J Obstet Gynecol 185(2):375–379
Dover SE, Aroutcheva AA, Faro S, Chikindas ML (2008) Natural antimicrobials and their role in vaginal health: a short review. Int J Probiotics Prebiotics 3(4):219–230
Hooper DC, Wolfson JS (1991) Fluoroquinolone antimicrobial agents. N Engl J Med 324(6):384–394
Tempera G, Furneri PM (2010) Management of aerobic vaginitis. Gynecol Obstet Invest 70(4):244–249
Choi SY, Chang CE, Kim SC, So JS (2003) Antimicrobial susceptibility and strain prevalence of Korean vaginal Lactobacillus spp. Anaerobe 9(6):277–280
Guay DR (2006) Moxifloxacin in the treatment of skin and skin structure infections. Ther Clin Risk Manag 2(4):417–434
Soussy CJ, Nguyen J, Goldstein F, Dabernat H, Andremont A, Leclercq R, Drugeon H, Cavallo P, Chardon H, Etienne J, Rio Y, Courvalin P (2003) In vitro antibacterial activity of moxifloxacin against hospital isolates: a multicentre study. Clin Microbiol Infect 9(10):997–1005
Sobottka I, Wegscheider K, Balzer L, Böger RH, Hallier O, Giersdorf I, Streichert T, Haddad M, Platzer U, Cachovan G (2012) Microbiological analysis of a prospective, randomized, double-blind trial comparing moxifloxacin and clindamycin in the treatment of odontogenic infiltrates and abscesses. Antimicrob Agents Chemother 56(5):2565–2569
Tempera G, Bonfiglio G, Cammarata E, Corsello S, Cianci A (2004) Microbiological/clinical characteristics and validation of topical therapy with kanamycin in aerobic vaginitis: a pilot study. Int J Antimicrob Agents 24(1):85–88
Speciale A, Musumeci R, Blandino G, Milazzo I, Caccamo F, Nicoletti G (2002) Minimal inhibitory concentrations and time-kill determination of moxifloxacin against aerobic and anaerobic isolates. Int J Antimicrob Agents 19(2):111–118
Nicolau DP (2001) Predicting antibacterial response from pharmacodynamic and pharmacokinetic profiles. Infection 29(Suppl 2):11–15
Thomas J, Linton S, Corum L, Slone W, Okel T, Percival SL (2012) The affect of pH and bacterial phenotypic state on antibiotic efficacy. Int Wound J 9(4):428–435
Yang L, Wang K, Li H, Denstedt JD, Cadieux PA (2014) The influence of urinary ph on antibiotic efficacy against bacterial uropathogens. Urology 84(3):731
Ball P, Stahlmann R, Kubin R, Choudhri S, Owens R (2004) Safety profile of oral and intravenous moxifloxacin: cumulative data from clinical trials and postmarketing studies. Clin Ther 26(7):940–950
Acknowledgments
This study was supported by the National Natural Science Fund of China (No. 81471419) and partially supported by grants from the Science Fund of Tianjin Medical University (No. 2013ky01).
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
All authors have read and have abided by the statement of ethical standards for manuscripts submitted to “European Journal of Clinical Microbiology & Infectious Diseases”. The study was reviewed and approved by the ethical committee of Tianjin Medical University General Hospital, and the participants were enrolled into the study after obtaining their written informed consent.
Conflict of interest
The authors declare that they have no conflict of interest.
Ethical approval
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.
Rights and permissions
About this article
Cite this article
Wang, C., Han, C., Geng, N. et al. Efficacy of oral moxifloxacin for aerobic vaginitis. Eur J Clin Microbiol Infect Dis 35, 95–101 (2016). https://doi.org/10.1007/s10096-015-2513-8
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10096-015-2513-8