Impact des antibiotiques sur la population des lactobacilles vaginaux chez la femme

Abstract

Most vaginal infections are treated by antibiotics but frequent recurrences and chronic infections are common due to the adverse effect on the indigenous lactobacilli. The types of antibiotics used to treat genital infections must not to kill the beneficial bacteria (lactobacilli) that help in preservation of vaginal health and ecosystem as being one of probiotic bacteria. The main goal of this study was to review the impact of antibiotics on vaginal lactobacilli specifically the two species L.reuteri and L.salivarius in order to avoid the overuse of antibiotics which have a detrimental effect on them. Twenty-seven vaginal lactobacilli isolated and identified in previous study were tested for their susceptibility to nine antibiotics from different class commonly used to treat vaginal disorders. The disc diffusion method in MRS agar was performed. The results suggest that all of the twenty-seven vaginal lactobacilli (88,89% L.reuteri and 11,11% L.salivarius) have variable sensitivity to antibiotics used. They are more sensitive to imipenem, moderate sensitivity to clindamycin, chloramphenicol and rifampicin, and less sensitive to ciprofloxacin, penicillin and gentamicin. On the other hand, all are resistant to vancomycin and nalidixic acid. Obtained data allow to conclude that therapy with vancomycin and nalidixic acid does not affect the number of L.reuteri and L.salivarius in the vagina. However, treatment with clindamycin, chloramphenicol, rifampicin, ciprofloxacin, penicillin and gentamicin can promote a decrease in these two species of lactobacilli in the vagina. In fact, treatment with imipenem should be avoided as it has a destructive effect on all L. reuteri isolates. It should be emphasized that the varying susceptibility of these friendly bacteria should be taken into account when choosing schemes antibacterial treatment.