Data on Safety of Intravaginal Boric Acid Use in Pregnant and Nonpregnant Women: A Narrative Review.
Data on Safety of Intravaginal Boric Acid Use in Pregnant and Nonpregnant Women: A Narrative Review.
复制标题
DOI：
10.1097/olq.0000000000001562
复制
发表时间：
2021-12-01
影响因子：
3.1
通讯作者：
Tuddenham, Susan
中科院分区：
文献类型：
--
作者：
Mittelstaedt, Rachel;Kretz, Alyssa;Levine, Michael;Handa, Victoria L.;Ghanem, Khalil G.;Sobel, Jack D.;Powell, Anna;Tuddenham, Susan
阴道内硼酸（IBA）是治疗唑类耐药外阴阴道念珠菌病（VVC）的唯一选择之一，并被纳入多个国家（包括英国和美国）VVC或复发性细菌性阴道病（BV）治疗指南的一部分。利用IBA的新产品正在开发中，用于治疗和抑制VVC和BV。非处方药（OTC）或临床医生处方的IBA在育龄妇女中的使用已经很普遍，如果VVC的耐药性上升，可能会进一步增加。然而，IBA不是FDA批准的药物，安全性数据很少。考虑到这些因素，了解目前关于IBA使用安全性的可用数据非常重要。在此，我们着手综合人类和动物数据（在适当情况下，将剂量和血清值转换为标准单位以便于比较），以回答两个关键问题：1.妇女使用IBA的安全性数据有哪些？和2.怀孕期间使用IBA的安全性数据有哪些？我们发现，尽管存在差距，但现有数据表明IBA的使用是安全的，至少在文献中通常描述为临床医生处方的剂量下使用时是安全的。关于怀孕危害的信息有限，数据仍然不足以改变目前建议怀孕期间避免IBA的指南。一项叙述性综述，总结了关于女性和妊娠期阴道内使用硼酸安全性的现有数据。
Intravaginal boric acid (IBA) represents one of the only options available to treat azole resistant vulvo-vaginal candidiasis (VVC), and is included as part of multiple national guidelines (including UK and US) for treatment of VVC or recurrent Bacterial Vaginosis (BV). Novel products utilizing IBA are under development for treatment and suppression of VVC and BV. Use of over the counter (OTC) or clinician-prescribed IBA in reproductive aged women is already widespread, and may increase further if drug resistance in VVC rises. Yet, IBA is not an FDA-approved drug and safety data are sparse. Given these factors, it is important to understand the currently available data on the safety of IBA use. Herein, we set out to synthesize human and animal data (converting, where appropriate, dose and serum values to standard units to facilitate comparison) to answer two key questions: 1. What are the data on the safety of IBA use for women? and 2. What are the data on the safety of IBA use in pregnancy? We find that, despite gaps, available data suggest IBA use is safe, at least when used in doses commonly described in the literature as being prescribed by clinicians. Information on harms in pregnancy is limited and data remain insufficient to change current guidelines which recommend IBA avoidance in pregnancy. A narrative review summarizing available data on the safety of intravaginal boric acid use for women and in the setting of pregnancy.