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Data on Safety of Intravaginal Boric Acid Use in Pregnant and Nonpregnant Women: A Narrative Review - PubMed

️Fri Jan 01 2021

Review

Data on Safety of Intravaginal Boric Acid Use in Pregnant and Nonpregnant Women: A Narrative Review

Rachel Mittelstaedt et al. Sex Transm Dis. 2021.

Erratum in

Erratum-Data on Safety of Intravaginal Boric Acid Use in Pregnant and Nonpregnant Women: A Narrative Review.
[No authors listed] [No authors listed] Sex Transm Dis. 2022 Jun 1;49(6):e78. doi: 10.1097/OLQ.0000000000001635. Epub 2022 Apr 9. Sex Transm Dis. 2022. PMID: 35404877 Review. No abstract available.

Abstract

Intravaginal boric acid (IBA) represents one of the only options available to treat azole-resistant vulvovaginal candidiasis (VVC) and is included as part of multiple national guidelines (including the United Kingdom and the United States) for the treatment of VVC or recurrent bacterial vaginosis. Novel products using IBA are under development for treatment and suppression of VVC and bacterial vaginosis. Use of over-the-counter or clinician-prescribed IBA in reproductive-aged women is already widespread and may increase further if drug resistance in VVC rises. However, IBA is not a Food and Drug Administration-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 2 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.

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Conflict of interest statement

Conflict of Interest and Sources of Funding: S.T. has been a consultant for Biofire Diagnostics, Roche Molecular Diagnostics, and Luca Biologics; receives royalties from UPTODATE; and has received speaker honoraria from Roche Molecular Diagnostics and Medscape. S.T. is supported by the National Institutes of Health (grant K23AI125715). A.P. receives royalties from UPTODATE. J.D.S. has served as a consultant to Scynexis Pharma and Mycovia Pharmaceuticals.

Cited by

Treatment of Vulvovaginal Candidiasis-An Overview of Guidelines and the Latest Treatment Methods.
Satora M, Grunwald A, Zaremba B, Frankowska K, Żak K, Tarkowski R, Kułak K. Satora M, et al. J Clin Med. 2023 Aug 18;12(16):5376. doi: 10.3390/jcm12165376. J Clin Med. 2023. PMID: 37629418 Free PMC article. Review.

References

1. Prutting SM, Cerveny JD. Boric acid vaginal suppositories: a brief review. Infect Dis Obstet Gynecol 1998;6(4):191–4. - PMC - PubMed
1. Iavazzo C, Gkegkes ID, Zarkada IM, Falagas ME. Boric acid for recurrent vulvovaginal candidiasis: the clinical evidence. J Womens Health 2002 2011. Aug;20(8):1245–55. - PubMed
1. Powell A, Ghanem KG, Rogers L, Zinalabedini A, Brotman RM, Zenilman J, et al. Clinicians’ Use of Intravaginal Boric Acid Maintenance Therapy for Recurrent Vulvovaginal Candidiasis and Bacterial Vaginosis. Sex Transm Dis 2019;46(12):810–2. - PMC - PubMed
1. Denning DW, Kneale M, Sobel JD, Rautemaa-Richardson R. Global burden of recurrent vulvovaginal candidiasis: a systematic review. Lancet Infect Dis 2018;18(11):e339–47. - PubMed
1. Workowski KA. Centers for Disease Control and Prevention Sexually Transmitted Diseases Treatment Guidelines. Clin Infect Dis Off Publ Infect Dis Soc Am 2015. Dec 15;61 Suppl 8:S759–762. - PubMed

Data on Safety of Intravaginal Boric Acid Use in Pregnant and Nonpregnant Women: A Narrative Review - PubMed