Study: 5-day BV antibiotic treatment flop

TL;DR

A recent study reveals that a 5-day course of the antibiotic moxifloxacin is not a one-size-fits-all solution for bacterial vaginosis (BV), as it fails to eliminate the bacterial biofilm in many cases. Despite some women experiencing significant clinical improvement, the stubborn nature of Gardnerella vaginalis biofilms means that alternative treatments, as discussed in our book ‘Killing BV’, may be necessary for effective management.

Antibiotic flop

Studies have repeatedly shown that antibiotics do not work for all women all the time when treating bacterial vaginosis because they cannot eliminate the bacterial biofilm. (We know how to do this – see our book Killing BV.)

One such study was conducted by Swidsinski, a BV pioneer (you have a lot to thank him for), to see if antibiotic moxifloxacin would work to get rid of the bacterial biofilm created by Gardnerella vaginalis. No such luck for everyone unfortunately, however for some women it did work. Twenty women with diagnosed BV were treated with 400mg moxifloxacin for five days.

The results were:

  • 15 women showed a significant clinical response to the moxifloxacin according to the Amsel criteria and Nugent score
  • Concentrations of adhesive bacteria reduced significantly
  • The incidence and proportion of Atopobium vaginae dropped significantly
  • The numbers of Lactobacillus in the biofilm mass increased, when at first, G. vaginalis was the main component of the polymicrobial biofilm. This was not the case after treatment.
  • After treatment, G. vaginalis was not accessible in 75 per cent of women
  • After 10-12 weeks the G. vaginalis biofilm was present in 40 per cent of the women
  • This has produced results similar to metronidazole so far as effectiveness goes

Study: Alexander Swidsinski et al, Response of Gardnerella vaginalis biofilm to 5 days of moxifloxacin treatment, 2011

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We’ve written a book detailing how to get rid of the bacterial biofilm caused by G. vaginalis. Check it out here.



Jessica Lloyd - Vulvovaginal Specialist Naturopathic Practitioner, BHSc(N)

Jessica is a degree-qualified naturopath (BHSc) specialising in vulvovaginal health and disease, based in Melbourne, Australia.

Jessica is the owner and lead naturopath of My Vagina, and is a member of the:

  • International Society for the Study of Vulvovaginal Disease (ISSVD)
  • International Society for the Study of Women's Sexual Health (ISSWSH)
  • National Vulvodynia Association (NVA) Australia
  • New Zealand Vulvovaginal Society (ANZVS)
  • Australian Traditional Medicine Society (ATMS)
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