Effect on Normal Vaginal Flora of Three Intravaginal Microbicidal Agents Potentially Active against Human Immunodeficiency Virus Type 1

• Published in: The Journal of infectious diseases Vol. 177; no. 5; pp. 1386 - 1390
• Main Authors: Rosenstein, Isobel J., Stafford, Michael K., Kitchen, Valerie S., Ward, Helen, Weber, Jonathan N., Taylor-Robinson, David
• Format: Journal Article
• Language: English
• Published: Chicago, IL The University of Chicago Press 01-05-1998; University of Chicago Press
• Subjects: Adult; AIDS/HIV; Anti-Bacterial Agents; Anti-HIV Agents - pharmacology; Anti-Infective Agents - pharmacology; Antibiotics. Antiinfectious agents. Antiparasitic agents; Antiinfectives; Bacteria; Bacteria - drug effects; Biological and medical sciences; Concise Communications; Dextrins; Dextrins - pharmacology; Dioctyl Sulfosuccinic Acid - pharmacology; Female; Flora; Gels; HIV 1; HIV-1 - drug effects; Humans; Lactobacillus - drug effects; Medical sciences; Miscellaneous. Antibiotics with multiple activities; Nonoxynol - pharmacology; Pharmacology. Drug treatments; Placebos; Sodium; Spermicides; Vagina - microbiology; Vaginal Smears; Volunteerism; Human; Intravaginal administration; Female genital system; Vagina; Female; Microflora; Biological activity; Antimicrobial agent
• ISSN: 0022-1899; 1537-6613
• DOI: 10.1086/517820

The effect on normal vaginal flora of three intravaginal microbicides potentially active against human immunodeficiency virus type 1 was examined. Volunteers received dextrin sulfate (D2S), nonoxynol-9 (N-9), or docusate sodium in separate placebo-controlled studies. High vaginal swabs were obtained for bacterial culture before and after microbicide application. D2S did not affect the vaginal flora. However, lactobacilli decreased by ⩾102 cfu/mL in 9 (56%) of 16 women given N-9 and in 5 (63%) of 8 women given docusate sodium. Women using N-9 were also significantly more likely to become colonized abnormally (usually with aerobic gram-negative rods) than were those using placebo, as were women using docusate sodium. Women with reduced lactobacilli were less likely to regain normal flora than were those whose lactobacilli were unaffected. However, coliform colonization occurred whether lactobacilli produced H2O2 or not. Continuous use of N-9 could induce susceptibility to urinary and gynecological infection. It is essential that potential microbicides are examined for activity against normal vaginal flora.