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Three patients with vulvovaginitis caused by Trichomonas vaginalis, which was refractory to conventional treatment with metronidazole are described. The T vaginalis strain isolated from one patient was resistant to metronidazole (minimum inhibitory concentration (MIC) more than 100 mg/l) under aerobic conditions, although under anaerobic conditions it was as susceptible as a normal reference strain. The effect of the concomitant use of other medication and the influence of other vaginal pathogens on the efficacy of metronidazole are highlighted. [ABSTRACT FROM PUBLISHER]

Ciprofloxacin was evaluated in chlamydial infections of the urogenital tracts of women treated with a dosage regimen of 500 mg orally twice a day for seven days. Of the 40 women evaluated, 30 were infected with Chlamydia trachomatis only, two were infected with Neisseria gonorrhoeae only, and a further eight had combined gonococcal and chlamydial infections. Ten were found to be harbouring Chlamydia trachomatis in the urethra as well as the cervix. Neisseria gonorrhoeae was eradicated from all patients with or without concomitant chlamydial infection. The overall chlamydial reisolation rates were 14% (5/35) four weeks after treatment and 23% (6/26) 11 weeks after treatment. The organism was not reisolated from the urethra of any of the patients after treatment. Ciprofloxacin was effective against Mycoplasma hominis, but almost completely ineffective against Ureaplasma urealyticum. [ABSTRACT FROM PUBLISHER]

OBJECTIVE--To evaluate the efficacy and safety of a 3 day course of intravaginal clindamycin 2% cream for the treatment of bacterial vaginosis. DESIGN--A prospective, randomised, double-blind placebo controlled study. SETTING--Departments of genitourinary medicine at Birmingham, Nottingham, Liverpool, Swansea, Leeds, Walsall, Stoke Mandeville, Southampton, Plymouth, Bishop's Stortford and Glasgow. SUBJECTS--Pre-menopausal women aged 18 years and over, who had symptomatic bacterial vaginosis were randomly allocated to receive either clindamycin 2% cream 5 grams (107 patients) or matching placebo cream (114 patients), daily for three days. Response to therapy was assessed at 7 days (Visit 2) and 28 days (Visit 3). RESULTS--221 patients with symptomatic bacterial vaginosis were enrolled to the study and of these 141 (63.8%) completed the study. On the "intent-to-treat" (ITT) analysis, 75% of the clindamycin group were classified as "success" or "improved" at visit 2 compared with 13% of the placebo group (p < 0.001). At Visit 3, 41% of the clindamycin group were classified as either "success" or "improved" versus 4% in the placebo group (p < 0.001). Of the 80 patients who were recorded "success" or "improved" at visit 2, 20 (25%) were reported to have a "recurrence" of BV at Visit 3. The meta-analysis on those who were evaluable at Visit 2 and 3 also showed that clindamycin cream 2% was an effective treatment for bacterial vaginosis, and the differences between the clindamycin group and the placebo group were statistically significant. CONCLUSION--We conclude that a 3 day course of clindamycin 2% cream is an effective, and well tolerated treatment for bacterial vaginosis. [ABSTRACT FROM PUBLISHER]

The incidence of Ureaplasma urealyticum in endourethral swabs was compared with that in first voided urine specimens from 171 male patients. The organism was isolated from the urethras of 72 (42%) and from the urine of 66 (39%). The interval since last voiding urine did not significantly influence the incidence of infection or ureaplasma counts in either type of specimen. Urethritis was strongly associated with ureaplasma counts of greater than or equal to 5 x 10(5) colour changing units (ccu)/ml in the urethra and greater than or equal to 5 x 10(3) ccu/ml in urine. [ABSTRACT FROM PUBLISHER]