title: Clinical antibiotic response of mycoplasma and ureaplasma in patients with symptomatic recurrent vulvovaginal colonization.
abstract: OBJECTIVE
  To assess the prevalence of mycoplasmas in symptomatic patients diagnosed with recurrent vulvovaginitis and to assess the response to doxycycline and ciprofloxacin.
  
  
  METHODS
  We conducted a retrospective medical records review of patients who consulted our private referral center for vulvovaginal disease between January 2004 and December 2008. The study included all the patients with positive culture for mycoplasma, ureaplasma or both and who received oral antibiotic therapy. The initial antibiotic therapy was with doxycycline, and persistent positivity was treated with ciprofloxacin. The center's Institutional Review Board approved the study.
  
  
  RESULTS
  The condition was assessed in 225 patients; 47 (24.4%) had a positive culture as follows: ureaplasma, 34 (72.3%), mycoplasma, 3 (6.4%) and both cultures positive was found in 10 (21.3%) of the patients. The initial clinical and bacteriologic response to doxycycline was observed in 25 (73.5%) patients, while 9 (26.5%) remained persistent positive (p = 0.03). Of the nonresponders 7 (77.8%) became bacteriologic negative with ciprofloxacin, and 2 (22.2%) remained positive (p = 0.23). The cost of each antibiotic was comparable: doxycycline at $12.33 per course and ciprofloxacin at $13.02 per course.
  
  
  CONCLUSIONS
  The prevalence of mycoplasma was 1.3%, ureaplasma 15.1% and both cultures positive 4.4%. The most effective response in our patients was with doxycycline.
authors.affiliation: Department of Obstetrics and Gynecology, Wright State University, Boonshoft School of Medicine, and Wright State Physicians Women's Health Care, Dayton, Ohio 45409, USA. gary.ventolini@wright.edu
authors.forename: Gary
authors.initials: G
authors.lastname: Ventolini
authors.forename: Monica
authors.initials: M
authors.lastname: Lee
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002939:Ciprofloxacin / Q000627:therapeutic use; D004318:Doxycycline / Q000627:therapeutic use; D005260:Female; D006801:Humans; D009174:Mycoplasma / Q000187:drug effects* / Q000302:isolation & purification; D009175:Mycoplasma Infections / Q000188:drug therapy; D012008:Recurrence; D012189:Retrospective Studies; D014509:Ureaplasma / Q000187:drug effects* / Q000302:isolation & purification; D016869:Ureaplasma Infections / Q000188:drug therapy; D014848:Vulvovaginitis / Q000188:drug therapy* / Q000382:microbiology*
chemical_list: D000900:Anti-Bacterial Agents; D002939:Ciprofloxacin; D004318:Doxycycline