TITLE:
Nystatin-Neomycin-Polymyxin B Combination: Efficacy and Tolerance as 1st-Line Local Treatment of Infectious Vaginitis
AUTHORS:
Jean-Marc Bohbot, Patrice Sednaoui, François Verriere
KEYWORDS:
Candidiasis, Mixed Vaginitis, Bacterial Vaginitis, Nystatin Neomycin, Polymyxin B, Empirical Therapy
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.4 No.7,
May
30,
2014
ABSTRACT: Objective: To evaluate the
efficacy and tolerance of a local treatment combining two antibacterials and
one antifungal in patients with a clinical presentation suggesting infectious
vaginitis. Patients and methods:
169 patients presenting with clinical criteria for vaginitis were included in
an open, multicenter trial. Vaginal samples were taken for microbiological
analyses and a triple-combination product of nystatin, neomycin and polymyxin B
was then started as local treatment, without waiting for the test results. The
treatment was continued with the usual dosage (1 vaginal capsule at bedtime for
12 days) for vaginal infections in the scope of the combination product with
approved labeling. A second vaginal sample was performed at the end of the
treatment. The main efficacy criterion was the clinical success rate (cure or
improvement of the clinical signs and symptoms) according to the investigator.Results:
93 patients were included in the efficacy population. Non-exclusively fungal
vaginitis (strictly bacterial or bacterial + fungal) represented 31.2% of the
cases. The clinical success rate was 97.8% according to the investigator and
95.7% according to the patients. The microbiological success rate was 81.3%,
with no differences between etiologies (Candida spp., bacteria or both).
The combination product was well-tolerated, despite the local inflammation
before treatment. Discussion and
conclusion: Given the etiological diversity of vaginitis, this trial supports
the efficacy of a triple-combination product (nystatin, neomycin, polymyxin B)
as a first-line local treatment of Candida,
bacterial or mixed vaginitis.