The potential effect on Neisseria gonorrhoeae of the use of clindamycin vaginal cream in the empirical treatment of vaginal discharge.
The minimum inhibitory concentrations (MIC) of clindamycin for 62 consecutive isolates of Neisseria gonorrhoeae were found to be 0.03-4 mg/L; the MIC50 and MIC90 were 0.125 and 2.0 mg/L respectively. Seven women treated with clindamycin vaginal cream had cervical mucus samples taken after seven days treatment. The concentrations of clindamycin achieved in the cervical mucus were 30-150 times higher (141-337 mg/L) than the highest MIC of the 62 N. gonorrhoeae isolates. Clindamycin vaginal cream is being used increasingly in Genitourinary Medicine clinics and General Practice for the treatment of bacterial vaginosis. This study shows that clindamycin vaginal cream achieves intra cervical concentrations that are high enough to inhibit N. gonorrhoeae. Empirical use of this therapy should be preceded by urethral and cervical swabs for N. gonorrhoeae in any woman at risk of gonorrhoeae.
Adu-Sarkodie
Y A
YA
Department of Clinical Sciences, London School of Hygiene and Tropical Medicine, UK.
Brook
M G
MG
Clark
S
S
Bendall
R
R
Kell
P D
PD
Atia
W A
WA
Kelsey
M C
MC
D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002981:Clindamycin / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D005260:Female; D006069:Gonorrhea / Q000188:drug therapy*; D006801:Humans; D009344:Neisseria gonorrhoeae / Q000187:drug effects*; D016585:Vaginosis, Bacterial / Q000188:drug therapy*
D000900:Anti-Bacterial Agents; D002981:Clindamycin