Bacterial vaginitis, so the medication is cheap and effective!

This article involves professional knowledge and is only for medical professionals to read for reference.
Never worry about bacterial vaginitis again! Who knows the pain of vaginal odor and heat pain for more than half a year? It makes many women immersed in pain and embarrassment.

It not only affects the normal life of women, but also has great harm to reproductive health.

"It" is bacterial vaginitis (BV), which is mainly manifested as increased vaginal discharge, fishy smell, aggravated after sexual intercourse, and may be accompanied by mild vulvar itching or burning.

The female vagina is not a "sterile environment", it is a complicated "jianghu".

Among them, Lactobacillus is the dominant vaginal bacteria under the physiological condition of women.
Bacteroides and Enterobacter are also colonized in the vagina.
The dominant state of Lactobacillus can restrict the proliferation of other flora.

When the "normal flora of Lactobacillus" decreases and the dominant bacteria do not exist, there will be "turmoil".

Why would I get BV? BV is a type of vaginal facultative anaerobes (such as Gardnerella vaginalis, Prevotella, Atopobium vaginalis, Bacteroides, Streptococcus spp, and kinetic Campylobacter) increase in the vagina.
The change of vaginal flora caused by the decrease or disappearance of the normal flora of hydrogen peroxide, Lactobacillus [1].

Common pathogens include facultative anaerobic bacteria (Gardnerella vaginalis), anaerobic bacteria (Prevotella, kinesobacteria, Bacteroides, vaginal atopus), Ureaplasma urealyticum, Mycoplasma hominis, etc.
[2].

Domestic survey data show that BV accounts for approximately 11% of women undergoing health examinations, and 36%-60% of women with vaginal inflammation in gynecological clinics.

At present, the cause of BV is not completely clear, but it may be related to multiple sexual partners, frequent sexual intercourse, repeated vaginal lavage and other factors.

Is metronidazole only used for BV treatment? The principle of treatment is to reduce the overgrowth of endogenous anaerobes and restore Lactobacillus as the dominant bacteria.

Comparing the "2020 ACOG Guidelines" [3], "European New Edition Guidelines", "US CDC Guidelines", and "my country's New Edition Guidelines", the treatment plans are slightly different, as follows: It is also "deadly" when recurring, and who tops it three times a year Can you survive? ▎Recurrent BV, how to take the medicine? The 2020 ACOG guidelines proposed for the first time that at least 3 independent BV authors diagnosed with recurrent BV within a year.

The recurrence rates within 3 months and 12 months after BV treatment were 30% and 58%, respectively.

Its recurrence may be related to vaginal douche, frequent sexual intercourse, BV history, persistent presence of pathogenic bacteria, or failure to rebuild the vaginal flora dominated by lactobacilli.

Patients with recurrence of symptoms should be checked and treated again.
Recurrent BV recommends metronidazole long-term vaginal medication, that is, metronidazole gel should be given twice a week for 16 weeks after acute treatment.
There is no optimal treatment plan.

 ▎How to treat BV during pregnancy and lactation? It is not uncommon for pregnant mothers and breastfeeding mothers to develop BV.
Due to changes in estrogen and progesterone levels, changes in vaginal mucosal immune function, and increased cervical mucus and vaginal secretions, the incidence of BV may increase.

So what kind of drug treatment can be selected considering the safety of the fetus and the baby? Regarding the safety of metronidazole during pregnancy and postpartum! Although metronidazole can pass through the placenta, a number of cross-sectional and cohort studies on pregnant women have not found evidence that the drug has a neonatal deformity or mutagenic effect; there are data that support the use of metronidazole during pregnancy to treat the risk of lower .

Metronidazole can be secreted through breast milk.
For mothers receiving oral administration, the infants who receive breastfeeding while receiving the drug will take in a much lower dose than newborns who receive the drug to treat infections, and are much lower than that of maternal blood.
The drug level is low.

Some clinicians still suggest that mothers should postpone breastfeeding for 12-24 hours after receiving metronidazole 2g, and when relatively low doses are administered, the concentration of the drug in the milk will be reduced accordingly, which is considered suitable for breastfeeding of.

Finally, it is worth noting that both editions of the US guidelines emphasize that at present, there is no research to support that lactobacillus preparations or probiotics can be used as alternative or auxiliary methods for the treatment or prevention of various vaginitis including BV.

However, the new version of my country's guide recommends that microecological preparations such as vaginal local lactobacillus preparations have a certain effect on assisting BV patients to restore the vaginal microecological balance, consolidate the efficacy and prevent recurrence.

The new European guidelines point out that the treatment of persistent or recurrent BV may be effective, such as vaginal lactic acid gel.

Interpretation of "2015 U.
S.
Centers for Disease Control and Prevention's Guidelines for Diagnosis and Treatment of Vaginal Inflammation"[J].
International Journal of Obstetrics and Gynecology,2015,42(6):676-679.
Source of this article: Obstetrics and Gynecology Channel of the Medical Circle Author of this article: Editor-in-Chief of Wang Xue: Sweet past review ☑ After being vaccinated with HPV vaccine, it was found that she was pregnant.
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