Use of locally delivered dequalinium chloride in the treatment of vaginal infections: a review.
BACKGROUND
Vaginal infections are responsible for a large proportion of gynaecological outpatient visits. Those are bacterial vaginosis (BV), vulvovaginal candidosis (VVC), aerobic vaginitis (AV) associated with aerobic bacteria, and mixed infections. Usual treatments show similar acceptable short-term efficacy, but frequent recurrences and increasing microbial resistance are unsolved issues. Furthermore, vaginal infections are associated with a variety of serious adverse outcomes in pregnancy and generally have a major impact on quality of life. Identifying the correct therapy can be challenging for the clinician, particularly in mixed infections.


RESULTS
Dequalinium chloride (DQC) is an anti-microbial antiseptic agent with a broad bactericidal and fungicidal activity. Systemic absorption after vaginal application of DQC is very low and systemic effects negligible. Vaginal DQC (Fluomizin vaginal tablets) has been shown to have equal clinical efficacy as clindamycin in the treatment of BV. Its broad antimicrobial activity makes it appropriate for the treatment of mixed vaginal infections and in case of uncertain diagnosis. Moreover, resistance of pathogens is unlikely due to its multiple mode of action, and vaginal DQC provides also a reduced risk for post-treatment vaginal infections.


CONCLUSIONS
Vaginal DQC (10 mg) as 6-day therapy offers a safe and effective option for empiric therapy of different vaginal infections in daily practice. This review summarizes the available and relevant pharmacological and clinical data for the therapy of vaginal infections with vaginal DQC and provides the rationale for its use in daily gynaecologic practice.
German Center for Infections in Gynecology and Obstetrics, Wuppertal, Germany. w.mendling@t-online.de.
Werner
W
Mendling
German Center for Infections in Gynecology and Obstetrics, Wuppertal, Germany.
Ernst Rainer
ER
Weissenbacher
Hospital Daler, Fribourg, Switzerland.
Stefan
S
Gerber
Medinova AG, Zurich, Switzerland.
Valdas
V
Prasauskas
Medinova AG, Zurich, Switzerland.
Philipp
P
Grob
D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D000891:Anti-Infective Agents, Local / Q000494:pharmacology* / Q000627:therapeutic use; D000935:Antifungal Agents / Q000494:pharmacology; D001419:Bacteria / Q000187:drug effects*; D001420:Bacteria, Aerobic; D002181:Candidiasis, Vulvovaginal / Q000175:diagnosis; D003868:Dequalinium / Q000494:pharmacology*; D005260:Female; D006801:Humans; D011247:Pregnancy; D011788:Quality of Life; D014622:Vaginal Creams, Foams, and Jellies / Q000627:therapeutic use*; D014623:Vaginal Diseases / Q000188:drug therapy / Q000382:microbiology*; D016585:Vaginosis, Bacterial / Q000382:microbiology
D000900:Anti-Bacterial Agents; D000891:Anti-Infective Agents, Local; D000935:Antifungal Agents; D014622:Vaginal Creams, Foams, and Jellies; D003868:Dequalinium
Aerobic vaginitis; Dequalinium chloride; Vaginal infections; Vaginal tablets; Vulvovaginal candidosis