***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: ABSTRACT To compare the frequencies , concentrations , and antimicrobial susceptibilities of vaginal microbes isolated from women with bacterial vaginosis ( BV ) before and after therapy , 119 nonpregnant women aged 18 to 45 with clinical and Gram stain evidence of BV were r and omized to receive intravaginal clindamycin or metronidazole . Vaginal swabs were collected at baseline and 7 to 12 days , 35 to 45 days , and 70 to 90 days following therapy for quantitative vaginal culture . For the 99 women completing all four visits , statistical analyses were performed comparing differences in vaginal microflora between the two treatment arms and between visits in the same treatment group . Antimicrobial susceptibility testing using the agar dilution method was performed for anaerobic gram-negative rods . Although both therapies result ed in decreased colonization by Gardnerella vaginalis and Mycoplasma hominis , only metronidazole treatment result ed in a significant decrease in the frequency and concentration of Prevotella bivia and black-pigmented Prevotella species . Of the 865 anaerobic gram-negative rods evaluated for susceptibility , only 3 ( 0.3 % ) were resistant to metronidazole , whereas clindamycin resistance increased significantly for P. bivia and black-pigmented anaerobic gram-negative rods persisting following clindamycin therapy . Clindamycin-resistant sub population s of P. bivia and black-pigmented Prevotella species emerged 7 to 12 days after therapy even among women colonized initially by clindamycin-susceptible strains . These resistant sub population s persisted at high frequencies ( 42 to 50 % ) 70 to 90 days following therapy . The two topical agents for treatment of BV have differing microbiologic effects on the vaginal microflora . The emergence of  clindamycin-resistant anaerobic gram-negative rods following therapy is of concern SUMMARY Objective : We evaluated the efficacy and tolerability of a new chlorhexidine-based bioadhesive vaginal gel ( Clomirex * ) in women with vaginal infections . Study design and subjects : A total of 90 non-pregnant women with vaginal infections of both bacterial ( bacterial vaginosis : BV ) or fungal ( vaginal c and idiasis VC ) origin , were enrolled in the study : a r and omised , controlled , 4-week , multicentre trial . Patients were r and omly treated with either chlorhexidine 0.5 % vaginal gel ( CHX-VG ) , 2.5 g or with metronidazole vaginal tablets 500 mg ( M ) or clotrimazole ( CL ) vaginal cream , depending on aetiology of the infection , daily for 7 days ( treatment phase ) in a 2:1 ratio . A total of 45 women had a diagnosis of BV and 45 a diagnosis of VC . Sixty women were treated with CHX-VG , 15 with M and 15 with CL . All patients were followed for an additional 3 weeks without treatments ( follow-up phase ) . For women with BV , clinical cure rate was defined as the disappearance of the following signs and symptoms : homogenous vaginal discharge ; presence of ≥ 2 or more clue cells at the wet mount microscopy ; a vaginal pH > 4.7 and a positive whiff test . For women with VC , clinical cure rate was defined as a resolution of signs and symptoms plus absence of hyphae , pseudohyphae and blastospores on 10 % KOH wet mount microscopy . Clinical cure rate was assessed at the end of the study ( week 4 ) by an investigator unaware of the patient 's treatment allocation . Results : At week 4 , in women with BV , 28 out of 30 ( 93 % ) women in the CHX-VG group were clinical ly cured in comparison with 11 out of 15 ( 74 % ) in the M group ( p = 0.3 ) . In women with VC , 26 out of 30 ( 86.6 % ) women in the CHX-VG group were clinical ly cured in comparison with 13 out of 15 ( 86 % ) in the CL group ( p = 0.5 ) . Tolerability was good and very good in 90 % of the CHX-VG patients . Six women ( 10 % ) complained of a mild transient burning sensation  after CHX-VG vaginal application . No serious adverse events were observed during the trial in all treated groups . No women presented with vaginal discharge after treatment . Conclusion : These results demonstrate that in the short term , this CHX-VG is an effective treatment for both bacterial and mycotic vaginal infections . Further clinical trials are warranted to evaluate the efficacy and tolerability profile of this new chlorhexidine vaginal gel on a long-term basis and in reducing recurrency rate of vaginal infections In a study of 100 women with non-specific vaginitis , characterised by a vaginal discharge which was malodorous and pruritic in most cases and caused dyspareunia and dysuria in some , Gardnerella vaginalis was isolated in 46 % of patients . When present , G vaginalis was significantly associated with Mycoplasma hominis and Bacteroides species . Isolation of G vaginalis was unrelated to the presenting symptoms . Treatment with povidone-iodine pessaries for two weeks produced no pronounced benefit , either clinical ly or microbiologically , compared with a placebo . Nevertheless , 68 % of all patients followed reported improvement four weeks after the start of treatment . The findings suggest that G vaginalis is one cause of non-specific vaginitis , which is more likely to be seen in women using oral contraceptives and is usually cured spontaneously Bacterial vaginosis ( BV ) is a common cause of abnormal malodorous vaginal discharge and can be frustrating to manage in its recurrent form . Metronidazole is the st and ard treatment , but is unacceptable to many women when given repeatedly . Results of treating recurrent BV using a single vaginal washout with 3 % hydrogen peroxide are analysed . A total of 30 symptomatic women with clinical ly confirmed recurrent BV in the absence of other genital infections were recruited after informed consent .  Hydrogen peroxide ( 3 % ) was instilled into the vagina , left for 3 minutes and drained . Re assessment was at 3 weeks after treatment . A total of 23 women completed the study .  Symptoms cleared completely in 78 % ( 18/ 23 ) , improved in 13 % ( 3/23 ) and remained unchanged in 9 % ( 2/23 ) . All the 3 women with improved symptoms had a mild vaginal discharge , but only one of them was still able to perceive the malodour . The amine test was negative in all 23 women including the 2 ( 9 % ) who felt no change in their symptoms following treatment . Mixed anaerobes isolated in all women before treatment were not re-isolated , and microscopy did not show ' clue cells ' in the vaginal discharge following treatment . Vaginal acidity was restored to normal in all but one ( 96 % ) . No side-effects were observed in the treated women . Hydrogen peroxide ( 3 % ) used as a single vaginal wash was as effective as any other agent in current use in clearing the vaginal malodour of bacterial vaginosis at 3 weeks after treatment OBJECTIVE This study was undertaken to evaluate antimicrobial susceptibility of vaginal anaerobic bacteria before and after treatment of bacterial vaginosis . STUDY DESIGN A r and omized clinical trial of 119 nonpregnant women with bacterial vaginosis receiving either intravaginal metronidazole for 5 days or clindamycin for 3 days was performed . Women had 1 baseline and 3 follow-up visits at which quantitative vaginal cultures were performed . Anaerobic isolates underwent antimicrobial susceptibility testing . RESULTS Complete susceptibility data was available on 95 women ( 47 metronidazole and 48 clindamycin ) . Of 1059 anaerobic bacterial isolates , less than 1 % demonstrated resistance to  metronidazole  . In contrast , 17 % demonstrated baseline  clindamycin resistance , and 53 % demonstrated resistance to  clindamycin  after therapy . Women exposed to clindamycin ( but not metronidazole ) had high frequencies ( 80 % ) of clindamycin-resistant anaerobic bacteria that persisted for 90 days after treatment . CONCLUSION Treatment of bacterial vaginosis with clindamycin is associated with marked evidence of antimicrobial resistance among vaginal anaerobic bacteria . This may increase the vaginal reservoir of macrolide-resistant bacteria This r and omised , double-blind , multicentric clinical study compared the efficacy and tolerability of the two vaginal antiseptics , 10 mg dequalinium chloride ( CAS 522 - 51 - 0 , Fluomycin N ) and 200 mg povidone iodine ( CAS 25655 - 41 - 8 ) , in a parallel-group design . A total of 180 patients with vaginal infections of varying etiology participated in this study ( bacterial vaginosis , fluor vaginalis , vulvo-vaginal c and idiasis , trichomoniasis ) . Patients were r and omly allocated to one of the two treatment groups and were treated once per day for 6 days . Control examinations took place 5 to 7 days after the end of treatment , and 3 to 4 weeks after the first control examination . The total symptoms score , a summary score for the clinical symptoms , discharge , burning , pruritus , redness of vulva/vagina , was defined as primary efficacy parameter . The treatments at the first control examination were compared in the full analysis set using the Wilcoxon-Mann-Whitney U-test , 2-sided , thereby proving equivalence of both treatments at the 5 % level . Both treatments strongly improved the symptoms of vaginal infections both on short-term and long-term follow-up . Descriptive analysis of the secondary parameters , vaginal pH , degree of purity of the vaginal flora , and number of lactobacilli in the wet mounts , supported the comparable efficacy of both therapies to restore the vaginal milieu . Analysis of the diagnostic subgroups indicated that irrespective of the diagnosis , both treatments improved the efficacy criteria as observed for the entire population . The global assessment of the therapeutic efficacy by investigators and patients supported the results of the efficacy analysis with good to very good ratings in 70 - 90 % of the cases . A good tolerability of both preparations was observed in this study with a low number of adverse events in the test group ( 5.8 % ) OBJECTIVE At the present the clinical treatment of choice of bacterial vaginosis ( BV ) is the use of systemic or local metronidazole or clindamycin . Aim of the study was to evaluate the efficacy and tolerability of a single dose of gynaecologic solution , Polyhexamethylene Biguanide ( PHMB ) , Monogin , in the treatment of BV in comparison to a 7-days treatment with clindamycin vaginal cream . STUDY DESIGN This multicenter , r and omized , single-blind , parallel-group study enrolled 740 patients with BV infections . Treatment consisted of either a single intravaginal dose of PHMB or 7 daily doses of Clindamycin .  Efficacy and safety were assessed 21 - 30 days after the start of treatment . The efficacy endpoints were Investigator Cure , Clinical Cure ( a composite of all 4 Amsel 's criteria and investigator Cure ) , Nugent Cure ( Nugent score < 4 ) , and therapeutic cure ( a composite of clinical cure and Nugent Cure ) . Resolution of individual Amsel 's criteria was also evaluated . Any adverse event of the treatment has been monitored throughout the study . RESULTS No significant differences has been reported in cure rates between the PHMB and Clindamycin treatment groups in Investigator Cure ( P = 0.702 ) , Clinical Cure ( P = 0.945 ) , Nugent Cure ( P = 0.788 ) , or Therapeutic Cure ( P = 0.572 ) . Results were also similar for 3 of 4 and 2 of 4 Amsel 's criteria and for each individual Amsel 's criterion ( all P-values > 0.200 ) . Ninety-five percent confidence intervals for each endpoint were consistent with equivalence between the 2 products . There was no significant difference between the treatment groups in the incidence of treatment-emergent adverse events ( P = 0.386 ) . CONCLUSIONS A single dose , of PHMB gynaecologic solution ( Monogin ) is equivalent in safety and efficacy to a 7-dose regimen of Clindamycin vaginal cream in the treatment of bacterial vaginosis . Futhermore the compliance as been reported to be higher for the single-dose treatment with PHMB than with 7-days treatment with Clindamycin Povidone-iodine pessaries ( Betadine vaginal pessaries ) containing 200 mg of povidone-iodine ( PVP-I ) in a water soluble base , are a widely used gynaecological preparation for treatment 
    Output:
    
There is insufficient evidence at present to advocate the use of these agents , although some studies suggest that some antiseptics may have equal efficacy compared to clindamycin or metronidazole .