Skip to main content

Biotherapeutic Agents as Therapy for Vaginitis

  • Chapter
Biotherapeutic Agents and Infectious Diseases

Abstract

For centuries, prior to the availability of modern antimicrobial agents, symptomatic vaginitis had been treated by a variety of home remedies. Included in this armamentarium has been crude preparations of microorganisms specifically given for the treatment of yeast or Candida vaginitis. The self-limiting nature of several forms of infectious vaginitis, together with the fact that most women with vaginal symptoms do not have infectious vaginitis per se, resulted in the acceptance of these “traditional” measures in the management of women with vaginal symptoms. Thus, before the Second World War, prior to the availability of systemic antimicrobial agents, an entire chemical arsenal had developed that was reasonably effective in different vaginal syndromes. Topical gentian violet and boric acid are a few of the chemical treatments that were reasonably effective in treating Candida vaginitis.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 109.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Doderlein, A. (1894) Die Scheidensekretuntersuchugen. Zentralbi. Gynakol. 18, 10–14.

    Google Scholar 

  2. Larsen, B. and Galask, R. P. (1982) Vaginal microbial flora: composition and influences of host physiology. Ann. Intern. Med. 96, 926–930.

    PubMed  CAS  Google Scholar 

  3. Larsen, B. and Galask, R. P. (1980) Vaginal microbial flora: practical and theoretical relevance. Obstet. Gynecol. 55, 100–113.

    Article  Google Scholar 

  4. Gorbach, S. L., Menda, K. B., Thadepalli, H., and Keith, L. (1973) Anaerobic microflora of the cervix in healthy women. Am. J. Obstet. Gynecol. 117, 1053–1055.

    PubMed  CAS  Google Scholar 

  5. Bartlett, J. G., Moon, N. E., Goldstein, P. R., Goren, B., Onderdonk, A. B., and Polk, B. F. (1978) Cervical and vaginal bacterial flora: ecologic niches in the female lower genital tract. Am. J. Obstet. Gynecol. 130, 658–661.

    PubMed  CAS  Google Scholar 

  6. Bartlett, J. G. and Polk, B. R. (1984) Bacterial flora of the vagina: quantitative study. Rev. Infect. Dis. 6, S67 - S72.

    Article  PubMed  Google Scholar 

  7. Levison, M. E., Corman, L. C., Carrington, E. R., and Kaye, D. (1977) Quantitative microflora of the vagina. Am. J. Obstet. Gynecol. 127, 80–85.

    PubMed  CAS  Google Scholar 

  8. Brown, W. J., Sautter, R. L., and Pickrum, H. M. (1980) Sequential quantitative evaluation of vaginal flora in regularly menstruating normal women. J. Clin. Microbiol. 11, 479–484.

    PubMed  Google Scholar 

  9. Hammann, R., Kronibus, A., Lang, N., and Werner, H. (1987) Quantitative studies on the vaginal flora of asymptomatic women and patients with vaginitis and vaginosis. Zbl. Bakt. Hyg. A. 265, 451–461.

    CAS  Google Scholar 

  10. Eschenbach, D. A., Davick, R. R., Williams, B. L, Klebanoff, S. J., Young-Smith, K., Critchlow, C. M., et al. (1989) Prevalence of hydrogen peroxide-producing Lactobacillus species in normal women and women with bacterial vaginosis. J. Clin. Microbiol. 27, 251–256.

    PubMed  CAS  Google Scholar 

  11. Bartlett, J. G., Onderdonk, A. B., Drude, E., Goldstein, C., Anderka, M., Alpert, S., et al. (1977) Quantitative bacteriology of the vaginal flora. J. Infect. Dis. 136, 271–277.

    Article  PubMed  CAS  Google Scholar 

  12. McCormack, W. M. (1980) The genital mycoplasmas I. N. Engl. J. Med. 302, 1003–1010.

    Article  PubMed  Google Scholar 

  13. McCormack, W. M. (1980) The genital mycoplasmas II. N. Engl. J. Med. 301, 1063–1067.

    Google Scholar 

  14. Paavonen, J. (1983) Physiology and ecology of the vagina. Scand. J. Infect. Dis. Suppl. 40, 31–35.

    PubMed  CAS  Google Scholar 

  15. Rogosa, M. and Sharpe, M. E. (1960) Species differentiation of human vaginal lactobacilli. J. Gen. Microbiol. 23, 197–201.

    PubMed  CAS  Google Scholar 

  16. Wylie, J. G. and Henderson A. (1969) Identity and glycogen-fermenting ability of lactobacilli isolated from the vagina of pregnant women. J. Med. Microbiol. 2, 363–366.

    Article  PubMed  CAS  Google Scholar 

  17. Giorgi, A., Torriani, S., Dellaglio, F., Bo, G., Stola, E., and Bernuzzi, L. (1987) Identification of vaginal lactobacilli from asymptomatic women. Microbiologica 10, 377–384.

    PubMed  CAS  Google Scholar 

  18. Skarin, A. and Sylwan, J. (1987) Vaginal lactobacilli inhibiting growth of Gardner-ella vaginales, Mobiluncus and other bacterial species cultured from vaginal content of women with bacterial vaginosis. Acta. Pathol. Microbiol. Immun. B. 94, 399–403.

    Google Scholar 

  19. Preti, G. and Higgins, G. R. (1975) Cyclical changes in volatile acidic metabolites of human vaginal secretions and their relation to ovulation. J. Chem. Ecol. 1, 361–376.

    Article  CAS  Google Scholar 

  20. Smith, H. (1977) Microbial surfaces in relation to pathogenicity. Bacterial. Rev. 41, 475–500.

    CAS  Google Scholar 

  21. Chan, R. C. Y., Bruce, A. W., and Reid, G. (1984) Adherence of cervical, vaginal and distal urethral normal microbial flora to human uroepithelial cells and the inhibition of adherence of gram-negative uropathogens by competitive exclusion. J. Urol. 131, 596–601.

    PubMed  CAS  Google Scholar 

  22. Reid, G., Chan, R. C. Y., Bruce, A. W., and Costerton, J. W. (1985) Prevention of urinary tract infections in rats with an indigenous Lactobacillus casei strain. Infect. Immun. 49, 320–324.

    PubMed  CAS  Google Scholar 

  23. Chan, R. C. Y., Reid, G., Irvin, R. T., Bruce, A. W., and Costerton, J. W. (1985) Competitive exclusion of uropathogens from human uroepithelial cells by Lactobacillus whole cells and cell wall fragments. Infect. Immun. 47, 84–89.

    PubMed  CAS  Google Scholar 

  24. Reid, G., Cook, R. L., and Bruce, A. W. (1987) Examination of strains of lactobacilli for properties that may influence bacterial interference in the urinary tract. J. Urol. 138, 330–335.

    PubMed  CAS  Google Scholar 

  25. Mardh, P. A. and Westrom, L. (1976) Adherence of bacteria to vaginal epithelial cells. Infect. Immun. 13, 661–666.

    PubMed  CAS  Google Scholar 

  26. Sobel, J. D., Schneider, J., Kaye, D., and Levison, M. E. (1981) Adherence of bacteria to vaginal epithelial cells at various times in the menstrual cycle. Infect. Immun. 31, 194–197.

    Google Scholar 

  27. Sobel, J. D., Myers, P., Levison, M. E., and Kaye D. (1981) C. albicans adherence to vaginal epithelial cells. J. Infect. Dis. 1143, 76–82.

    Google Scholar 

  28. Dahiya, R. S. and Speck, M. L. (1986) Hydrogen peroxide formation by lactobacilli and its effect on Staphylococcus aureus. J. Diary Sci. 51, 1568–1572.

    Article  Google Scholar 

  29. Klebanoff, S. J. and Smith, D. C. (1970) Peroxidase-mediated antimicrobial activity of rat uterine fluid. Gynecol. Invest. 1, 21–30.

    Article  PubMed  CAS  Google Scholar 

  30. Hillman, J. D. and Shivers, M. (1988) Interaction between wild-type mutant and revertant forms of the bacterium Streptococcus sanguis and the bacterium Actinobacillus actin-mycetemcomitans in vitro and in the gnotobiotic rat. Archs. Oral Biol. 33, 395–401.

    Article  CAS  Google Scholar 

  31. Hawes, S. E., Hillier, S. L., Benedetti, J., Stevens, C. E., Kautsky, L., and WolnerHanssen, P., Holmes, K. K. (1996) Hydrogen peroxide-producing lactobacilli and acquisition of vaginal infections. J. Infect. Dis. 174, 1058–1063.

    CAS  Google Scholar 

  32. Klebanoff, S. J., Hillier, S. L., Eschenbach, D. A., and Waltersdorph, A. M. (1991) Control of the microbial flora of the vagina by H202-generating Lactobacilli. J. Infect. Dis. 169, 94–109.

    Article  Google Scholar 

  33. Tagg, J. R., Dajani, A. S., and Wannamaker, L. W. (1976) Bacteriocins of gram-positive bacteria. Bacteriol. Rev. 40, 722–756.

    PubMed  CAS  Google Scholar 

  34. Andersson, R. E., Daeschel, M. A., and Hassan, H. N. (1988) Antibacterial activity of plantacirin SIK-83, a bacteriocin produced by Lactobacillus plantarum. Biochimie 70, 381–390.

    Article  CAS  Google Scholar 

  35. Barefoot, S. F. and Klaenhammer, T. R. (1983) Detection and activity of lactacin B, a bacteriocin produced by Lactobacillus acidophilus. Appl. Environ. Microbiol. 45, 1808–1815.

    CAS  Google Scholar 

  36. Silva, M., Jacobus, N. V., Deneke, C., and Gorbach, S. L. (1987) Antimicrobial substance from a human Lactobacillus strain. Antimicrob. Agents Chemother. 31, 1231–1233.

    Article  PubMed  CAS  Google Scholar 

  37. Vandenbergh, P. A. (1993) Lactic acid baceria, their metabolic product and interference with microbial growth. FEMS Microbiol. Rev. 12, 221–238.

    Article  CAS  Google Scholar 

  38. Axelsson, L. T., Chung, T. C., Dobrogosz, W. J., and Jindgren, S. E. (1989) Production of a broad spectrum antimicrobial substance by Lactobacillus reuteri. Microb. Ecology Health Dis. 2, 131–136.

    Article  Google Scholar 

  39. Reid, G., McGroarty, J. A., Angotti, R., and Cook, R. L. (1988) Lactobacillus inhibitor production against Escherichia coli and coaggregation ability with uropathogens. Can. J. Microbiol. 34, 344–351.

    CAS  Google Scholar 

  40. Perdigon, G., de Macias, M. E. N., Alvarez, S., Oliver, G., and de Ruiz Holgado, A. P. (1988) Systemic augmentation of the immune response in mice by feeding fermented milks with Lactobacillus casei and Lactobacillus acidophilus. Immunology 63, 17–23.

    CAS  Google Scholar 

  41. Sobel, J. D. (1993) Candidal vulvovaginitis. Clin. Obstet. Gynecol. 36, 153–166.

    Article  PubMed  CAS  Google Scholar 

  42. Sobel, J. D., Faro, S., Force, R. W., Foxman, B., Ledger, W. J., Nyirjesy, P. R., et al. (1998) Vulvovaginal candidiasis: epidemiologic, diagnostic and therapeutic considerations. Am. J. Obstet. Gynecol.,in press.

    Google Scholar 

  43. Hillier, S. L., Krohn, M. A., Rabe, L. K., Klebanoff, S. J., and Eschenbach, D. A. (1993) The normal vaginal flora, H202-producing lactobacilli and bacterial vaginosis in pregnant women. Clin. Infect. Dis. 16 (Suppl.), s273 - s281.

    Article  PubMed  Google Scholar 

  44. Hillier, S. L., Krohn, M. D., Klebanoff, S. J., and Eschenbach, D. A. (1992) The relationship of hydrogen-peroxide producing lactobacilli to bacterial vaginosis and genital microflora in pregnant women. Obstet. Gynecol. 79, 369–373.

    Article  PubMed  CAS  Google Scholar 

  45. Bluestein, D., Rutledge, C., and Lumsden, L. (1991) Predicting the occurrence of antibiotic-induced Candidal vaginitis. Fam. Pract. Res. J. 11, 319–326.

    PubMed  CAS  Google Scholar 

  46. Agnew, K. J. and Hillier, S. L. (1995) The effect of treatment regimens for vaginitis and cervicitis on vaginal colonization by lactobacilli. Sex. Transm. Dis. 22, 269–273.

    Article  PubMed  CAS  Google Scholar 

  47. Larsen, B. and White, S. (1995) Antifungal effect of hydrogen peroxide on catalaseproducing strains of Candida spp. Infect. Dis. Obstet. Gynecol. 3, 73–78.

    Article  PubMed  CAS  Google Scholar 

  48. Sobel, J. D. and Chaim, W. (1996) Vaginal microbiology of women with acute recurrent vulvovaginal candidiasis. J. Clin. Microbial. 34, 2497–2502.

    CAS  Google Scholar 

  49. Hilton, E., Isenberg, H. D., Alperstein, P., France, K., and Borenstein, M. T. (1992) Ingestion of yogurt containing a Lactobacillus acidophilus as prophylaxis for Candida vaginitis. Ann. Int. Med. 116, 353–357.

    CAS  Google Scholar 

  50. Hilton, E., Rindos, P., and Isenberg, H. D. (1995) Lactobacillus GG vaginal suppositories and vaginitis. J. Clin. Microbial. 33, 1433.

    CAS  Google Scholar 

  51. McGroarty, J. A. (1993) Probiotic use of lactobacilli in the human female urogenital tract. FEMS Immunol. Med. Microbial. 6, 251–264.

    Article  CAS  Google Scholar 

  52. Reid, G., Bruce, A. W., McGroarty, J. A., Cheng, K. J., and Costerton, J. W. (1990) Is there a role for Lactobacilli in prevention of urogenital and intestinal infections? Clin. Microbial. Rev. 3, 335–344.

    CAS  Google Scholar 

  53. Hughes, V. L. and Hillier, S. L. (1990) Microbiologic characteristics of Lactobacillus products used for colonization of the vagina. Obstet. Gynecol. 75, 244–288.

    PubMed  CAS  Google Scholar 

  54. Hillier, S. L. and Holmes, K. K. (1990) Bacterial vaginosis, in Sexually Transmitted Diseases ( Holmes, K. K., Mardh, P. A., Sparling, P. F., et al., eds.), McGraw-Hill, New York, pp. 547–560.

    Google Scholar 

  55. Hill, G. B. (1993) Microbiology of bacterial vaginosis. Am. J. Obstet. Gynecol. 169, 450–454.

    PubMed  CAS  Google Scholar 

  56. Gardner, H. and Dukes, C. D. (1995) Hemophilus vaginalis vaginitis a new defined specific infection previously classified “non-specific” vaginitis. Am. J. Obstet. Gynecol. 69, 962–976.

    Google Scholar 

  57. Pheifer, T. A., Forsyth, P. S., and Durfee, N. A. (1978) Nonspecific vaginitis: role of Gardnerella vaginalis and treatment with metronidazole. N. Engl. J. Med. 298, 1429–1434.

    Article  PubMed  CAS  Google Scholar 

  58. Eschenbach, D. A., Critchlow, C. W., Watkins, H., Smith, K., Spiegel, C. A., Chen, K. C. S., et al. (1983) A dose duration study of metronidazole for the treatment of non-specific vaginosis. Scand. J. Infect. Dis. 40 (Suppl.), 73–80.

    CAS  Google Scholar 

  59. Livengood, C. H., McGregor, J. A., Soper, D. E, Newton, E. and Thomason J. H. (1994) Bacterial vaginosis: efficacy and safety of intravaginal metronidazole therapy. Am. J. Obstet. Gynecol. 170, 759–764.

    PubMed  Google Scholar 

  60. Ahmed-Justicef, I. H., Shahmanesh, M., and Arya, O. P. (1995) The treatment of bacterial vaginosis with a 3 day course of 2% clindamycin cream: results of a multicenter, double-blind, placebo controlled trial. Genitourin. Med. 71, 254–256.

    Google Scholar 

  61. Blackwell, A. L., Phillips, I., Fox, A. R., and Barlow, D. (1983) Anerobic vaginosis (non-specific vaginitis): clinical microbiological, and therapeutic findings. Lancet 11, 1379–1382.

    Article  Google Scholar 

  62. Cook, R. L., Redondo-Lopez, V., Schmitt, C., Meriwether, C., and Sobel, J. D. (1992) Clinical microbiological and biochemical factors in recurrent bacterial vaginosis. J. Clin. Microbiol. 30, 870–877.

    PubMed  CAS  Google Scholar 

  63. Sobel, J. D. and Leaman, D. Successful maintenance suppressive therapy of recurrent bacterial vaginosis with long term use of metronidazole gel. Submitted for publication.

    Google Scholar 

  64. Sobel, J. D. (1994) Desquamative inflammatory vaginitis—a new subgroup of purulent vaginitis responsive to topical 2% clindamycin therapy. Am. J. Obstet. Gynecol. 171, 1215–1220.

    PubMed  CAS  Google Scholar 

  65. Fleury, F. J. (1981) Adult vaginitis. Clin. Obstet. Gynecol. 24, 407–438.

    Article  PubMed  CAS  Google Scholar 

  66. Zheng, H. Y., Alcorn, T. M., and Cohen, M. S. (1994) Effects of H202-producing lactobacilli on Neisseria gonorrhoeae growth and catalase activity. J. Infect. Dis. 170, 1209–1215.

    Article  PubMed  CAS  Google Scholar 

  67. Hallén, A., Jarstrand, C., and Pahlson, C. (1992) Treatment of bacterial vaginosis with lactobacilli. Sex. Trans. Dis. 19, 146–148.

    Article  Google Scholar 

  68. Hillier, S. L., Krohn, M. A., Nugent, R. P., and Gibbs, R. S. (1992) Characteristic of three vaginal flora patterns assessed by Gram stain among pregnant women. Am. J. Obstet. Gynecol. 166, 938–944.

    PubMed  CAS  Google Scholar 

  69. Pahlson, C. and Larsson, P. G. (1991) The ecologically wrong vaginal lactobacilli. Med. Hypotheses 36, 126–130.

    Article  PubMed  CAS  Google Scholar 

  70. Reid, G., Millsap, K., and Bruce, A. W. (1994) Implantation of Lactobacillus casei versus rhamnosus into the vagina. Lancet 344, 1229.

    Article  PubMed  CAS  Google Scholar 

  71. McGroarty, J. A., Tomaczek, L., Pond, D. G., Reid, G., and Bruce, A. W. (1992) Hydrogen peroxide production of Lactobacillus species: correlation with susceptibility to the spermicidal compound nonoxynol-9. J. Infect. Dis. 165, 1142–1144.

    Article  PubMed  CAS  Google Scholar 

  72. Sussman, J. I., Baron, E. J., Goldberg, S. M., Kaplan, M. H., and Pizzarello, R. A. (1986) Clinical manifestations and therapy of lactobacillus endocarditis: report of a case and review of the literature. Rev. Infect. Dis. 8, 771–776.

    Article  PubMed  CAS  Google Scholar 

Download references

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 1999 Springer Science+Business Media New York

About this chapter

Cite this chapter

Sobel, J.D. (1999). Biotherapeutic Agents as Therapy for Vaginitis. In: Elmer, G.W., McFarland, L.V., Surawicz, C.M. (eds) Biotherapeutic Agents and Infectious Diseases. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-59259-711-6_10

Download citation

  • DOI: https://doi.org/10.1007/978-1-59259-711-6_10

  • Publisher Name: Humana Press, Totowa, NJ

  • Print ISBN: 978-1-4757-4652-5

  • Online ISBN: 978-1-59259-711-6

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics