IN VITRO ANTIMICROBIAL ACTIVITY OF Schinus terebinthifolia Raddi METRONIDAZOLE, CLINDAMYCIN AGAINST Lactobacillus gasseri Lauer and Kandler AND ITS IMPLICATIONS IN RECURRENT BACTERIAL VAGINOSIS

Abstract

Bacterial vaginosis (BV) is very prevalent and is the most common cause of vaginal discharge worldwide. It is a dysbiosis resulting from the replacement of hydrogen peroxide and lactic acid-producing lactobacilli by anaerobic bacteria in high concentrations, including Gardnerella vaginalis, Prevotella, Mobiluncus, Atopobium and other anaerobes. BV can be self-diagnosed when the patient presents the classic symptoms, or clinically and laboratory-based, following the Amsel criteria or by determining the Nugent score. The recommended treatments for BV are oral metronidazole, secnidazole and tinidazole, as well as vaginal metronidazole gel, clindamycin cream and Schinus terebinthifolia Raddi gel. The present study aimed to determine the ability of vaginal clindamycin cream, vaginal metronidazole gel and S. terebinthifolia Raddi vaginal gel to inhibit the growth or preserve the population of Lactobacillus gasseri ATCC 19992 microorganisms in vitro. The methodology used was perforation in plates, forming 6 mm wells, where the samples were inoculated. The plates were incubated for 48 hours at 30°C. After this period, by visual plates analysis, was observed that L. gasseri is resistant to S. terebinthifolia Raddi vaginal gel since no inhibition halo was observed. However, L. gasseri was moderately susceptible to Metronidazole vaginal gel and highly sensitive to Clindamycin vaginal cream. As lactobacilli, of which L. gasseri stands out, represent over 95% of the microorganisms 3/16 that inhabit the vaginal environment, maintaining the health of this microbiome, the action of Clindamycin and Metronidazole can lead to an imbalance in the vaginal microbiota, allowing relapses when these therapeutic agents are used to treat BV.