Treatment of Staphylococcus Vaginal Infection

Diagnosis and Assessment

• The Centers for Disease Control and Prevention recommends confirming diagnosis through clinical examination showing signs of vaginitis, culture or other tests yielding a positive result for Staphylococcus species, and wet preparation or Gram stain of vaginal discharge to rule out other common causes of vaginitis 2, 3

Treatment Options

• The Centers for Disease Control and Prevention recommends topical therapy with clindamycin cream 2%, one full applicator (5g) intravaginally at bedtime for 7 days 1
• For methicillin-resistant Staphylococcus aureus (MRSA), the Infectious Diseases Society of America recommends trimethoprim-sulfamethoxazole, clindamycin 600mg orally three times daily, or doxycycline or minocycline (not for children <8 years) 4, 5

Special Considerations

• For severe infections with systemic symptoms or extensive involvement, hospitalization may be required and intravenous vancomycin is recommended for serious MRSA infections 4, 5, 6
• Clindamycin cream should be used with caution during pregnancy due to potential increase in adverse events (prematurity and neonatal infections) 1

Prevention and Follow-up

• Maintaining good personal hygiene with regular bathing and hand washing, keeping any draining wounds covered with clean, dry bandages, and focusing cleaning on high-touch surfaces that may contact bare skin can help prevent infection 4, 5
• Follow-up visits are unnecessary if symptoms resolve, but patients should return for additional therapy if symptoms recur 1

Common Pitfalls and Caveats

• Routine treatment of sex partners is not recommended based on clinical trials showing that a woman's response to therapy and likelihood of relapse are not affected by partner treatment 1
• Cultures should be obtained in patients who do not respond to initial treatment to guide antibiotic selection 4, 6