Therapy of Aerobic Vaginitis and ClinicallyUncertain Causes of Vulvovaginal Discomfort

Overview

Objective:
The treatment of clinically uncertain conditions of vaginal discomforts with a mixedpreparation of nifuratel + nystatin (Macmiror complex) and the relation of uncertain conditionsto aerobic vaginitis.Design: A prospective study.Setting: Gynecology-Obstetrics Outpatient Department LEVRET Ltd., AescuLab Ltd., Laboratoryof Microbiology, Prague.Methods: 50 women with vaginal discomfort, causes of which had not been clarifi ed bygynecological examination, determination of pH and the amine test, were examined by vaginalsmears using microscopy. The results were evaluated in relation to aerobic vaginitis in a pureform or in combination with other nosological units. The authors also evaluated results oftherapy by oral nifuratel (Macmiror tbl) 3 x 200 mg daily and a vaginal combined preparationcontaining nifuratel 500 mg + nystatin 200 kIU (Macmiror complex 500 glo vag) for the period of7 days.Results: In 50 women candida was demonstrated 24 times, presence of key cells 11 times,lactobacillus nine times with more than 50 in the fi eld, six women were affected by aerobicvaginitis. In all these cases the pH was 4.8 or higher, leukocytes were signifi cantly representedin all cases (>15 in the fi eld), as well as gram-negative bacteria and/or cocci (>30 in the fi eld),indicating a combined picture of mycosis, anaerobic vaginosis or lactobacillosis with aerobicvaginitis. The therapy was successful in all cases, the relapse of complaints during one monthoccurred in three cases.Conclusions: Aerobic vaginitis in a pure form or with anaerobic vaginosis, mycosis orlactobacillosis is frequently concealed under clinically uncertain pictures of vulvo-vaginal discomfort. The therapy by a combination of nifuratel 3 x 200 mg orally together with thecombined vaginal preparation nifuratel 500 mg + nystatin 200 kIU for the period of 7 days exertshigh effect and a low number of relapses.

Key words:
vulvovaginal discomfort, aerobic vaginitis, nifuratel, nystatin