Vaginal Honey as an Adjuvant Therapy for Standard Antibiotic Protocol of Cervicitis: a Randomized Clinical Trial

Document Type : Original paper

Authors

1 Department of Obstetrics and Gynecology, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran.

2 Department of Pharmaceutics, School of Pharmacy, Zanjan University of Medical Sciences, Zanjan, Iran.

3 Department of Pharmacognosy, School of Pharmacy, Zanjan University of Medical Sciences, Zanjan, Iran.

Abstract

Background and objectives: More than half of the cervicitis cases are non-gonococcal and non-chlamydial. Therefore, the cure rate of the principal treatment protocol has reduced to less than 50%. Complementary therapy is an option for adjuvant therapy when standard medical treatment is not effective enough. Honey is used as a natural agent for wound healing and antibacterial effect. This study aimed to compare the effect of honey adjuvant therapy with the standard antibiotic therapy in improving the cure rate of cervicitis. Methods: In this double-blind randomized clinical trial, we enrolled 102 women diagnosed with cervicitis with standard criteria who referred to the gynecological clinic of Mousavi Hospital, Zanjan, Iran. They were randomly divided into two groups. The control group received the oral standard antibiotic treatment plus lubricant gel as placebo, and the intervention group received the oral standard treatment plus vaginal Ziziphus honey as adjuvant therapy. Both groups received the treatment once a day for two weeks. The symptoms and clinical findings of the patients were evaluated for three weeks following the initiation of the treatments. Results: All clinical symptoms of cervicitis significantly decreased after the treatment in both groups (p≤0.05), but the vaginal discharge of the intervention group reduced more (p≤0.05). In addition, the intervention group showed better results for the restoration of cervical erosion in comparison with the control group (p<0.05). Conclusion: Vaginal honey adjuvant therapy can improve the efficiency of standard antibiotic treatment to reduce the clinical symptoms of cervicitis.
 

Keywords

Main Subjects


  • Marrazzo JM, Martin DH. Management of women with cervicitis. Clin Infect Dis. 2007; 44(S3): 102–1
  • Landers DV, Wiesenfeld HC, Heine RP, Krohn MA, Hillier SL. Predictive value of the clinical diagnosis of lower genital tract infection in women. Am J Obstet Gynecol. 2004; 190(4): 1004–100
  • Woods JL, Bailey SL, Hensel DJ, Scurlock AM. Cervicitis in adolescents: do clinicians understand diagnosis and treatment? J Pediatr Adolesc Gynecol. 2011; 24(6): 359–3
  • Lusk MJ, Garden FL, Rawlinson WD, Naing ZW, Cumming RG, Konecny P. Cervicitis aetiology and case definition: a study in Australian women attending sexually transmitted infection clinics. Sex Transm Infect. 2016; 92(3): 175–1
  • Keshavarz H, Duffy S, Sadeghi-Hassanabadi A, Zolghadr Z, Oboodi B. Risk factors for and relationship between bacterial vaginosis and cervicitis in a high risk population for cervicitis in Southern Iran. Eur J Epidemiol. 2001; 17(1): 89–
  • Nugent RP, Krohn MA, Hillier SL. Reliability of diagnosing bacterial vaginosis is improved by a standardized method of gram stain interpretation. J Clin Microbiol. 1991; 29(2): 297–
  • Keshavarz H, Duffy S, Sotodeh-Maram E, Saraf Z, Sadeghi-Hassana-Badi A, Zighami B. Factors related to cervicitis in Qashghaee nomadic women of southern Iran. Rev Epidemiol Sante Publique. 1997; 45(4): 279–2
  • Taylor SN, Lensing S, Schwebke J, Lillis R, Mena LA, Nelson AL. Prevalence and treatment outcome of cervicitis of unknown etiology. Sex Transm Dis. 2013; 40(5): 379–3
  • Workowski KA,  Bolan Sexually transmitted diseases treatment guidelines. MMWR Recomm Rep. 2015; 64(3):1–137.
  • Hocking JS, Vodstrcil LA, Huston WM, Timms P, Chen MY, Worthington K. A cohort study of Chlamydia trachomatis treatment failure in women: a study protocol. BMC Infect Dis. 2013; 13(1): 1–9.
  • Schwebke JR, Weiss HL. Interrelationships of bacterial vaginosis and cervical inflammation. Sex Transm Dis. 2002; 29(1): 59–
  • Eisenberg DM, Davis RB, Ettner SL, Appel S, Wilkey S, Van Rompay M. Trends in alternative medicine use in the United States, 1990-1997: results of a follow-up national survey. Obstet Gynecol Surv. 1999; 54(6): 370–37
  • Zargaran A, Zarshenas MM, Karimi A, Yarmohammadi H, Borhani-Haghighi A. Management of stroke as described by Ibn Sina (Avicenna) in the Canon of medicine. Int J Cardiol. 2013; 169(4): 233–23
  • Lusby PE, Coombes AL, Wilkinson JM. Bactericidal activity of different honeys against pathogenic bacteria. Arch Med Res. 2005; 36(5): 464–46
  • Banaeian-Borujeni S, Taghipoor S. In vitro comparison of the effect of honey and clotrimazole against Candida albicans isolated from vagina. Adv Herb Med. 2015; 1(1): 42–4
  • Abdelmonem AM, Rasheed SM, Mohamed AS. Bee-honey and yogurt: a novel mixture for treating patients with vulvovaginal candidiasis during pregnancy. Arch Gynecol Obstet. 2012; 286(1): 109–11
  • Nabati F, Khalighi-Sigaroodi F, Kashefi M, Ghasemi SV, Sadri H, Tajabadi F. Evaluating the quality of commercial Iranian honeys. J Med Plants. 2021; 20(78): 14–25.
  • Mavric E, Wittmann S, Barth G, Henle T. Identification and quantification of methylglyoxal as the dominant antibacterial constituent of Manuka (Leptospermum scoparium) honeys from New Zealand. Mol Nutr Food Res. 2008; 52(4): 483–48
  • White Jr JW, Subers MH, Schepartz AI. The identification of inhibine, the antibacterial factor in honey, as hydrogen peroxide and its origin in a honey glucose-oxidase system. Biochim Biophys Acta. 1963; 73(1): 57–
  • Nabimeybodi R, Meyari A, Vahiddastjerdi M, Hajimehdipoor H, Ghasemi E, Bioos S. The effect of flixweed-honey vaginal product on cervicitis: a clinical trial. Res J Pharmacogn. 2018; 5(2): 41–4
  • Mattson SK, Polk JP, Nyirjesy P. Chronic cervicitis: presenting features and response to therapy. J Low Genit Tract Dis. 2016; 20(3): 30–3
  • Imhof M, Lipovac M, Kurz C, Barta J, Verhoeven H, Huber J. Propolis solution for the treatment of chronic vaginitis. Int J Gynaecol Obstet. 2005; 89(2): 127–1
  • Al-Waili NS. Investigating the antimicrobial activity of natural honey and its effects on the pathogenic bacterial infections of surgical wounds and conjunctiva. J Med Food. 2004; 7(2): 210–2
  • Dunford C, Cooper R, Molan P, White R. The use of honey in wound management. Nurs Stand. 2000; 15(11): 63–38.
  • Oryan A, Alemzadeh E, Moshiri A. Biological properties and therapeutic activities of honey in wound healing: a narrative review and meta-analysis. J Tissue Viability. 2016; 25(2): 98–
  • Al-Waili N, Salom K, Al-Ghamdi AA. Honey for wound healing, ulcers, and burns; data supporting its use in clinical practice. Sci World J. 2011; 11: 766–787.