Table 1.

In vitro data on antibiotic drug resistance in BV-associated bacteria.

First Author, Year	Bacterial Species, Number of Isolates Tested	Antibiotics Used in Susceptibility Testing	Results	Conclusions
Nagaraja, 2008 [19]	50 clinical isolates of G. vaginalis	MTZ, clindamycin	34 (68%) of isolates resistant to MTZ; 38 (76%) of isolates sensitive to clindamycin	Clindamycin is better in eradicating G. vaginalis than MTZ in vitro
Petrina, 2017 [21]	605 BVAB	MTZ, TDZ, SEC, clindamycin	MIC90 for SEC was similar to MTZ and TDZ for A. tetradius, A. vaginae, Bacteroides spp., F. magna, G. vaginalis, M. indolicus, Megasphaera-like bacteria, M. curtisii, M. mulieris, P. lacrimalis, P. harei, Porphyromonas spp., P. bivia, P. amnii, and P. timonensis. A proportion of P. bivia (40%), P. amnii (14%), and P. timonensis (58%) isolates were resistant to clindamycin with MIC values > 128 µg/mL. MTZ and SEC were superior to clindamycin for Prevotella spp., Bacteroides spp., A. tetradius, and F. magna. In contrast, clindamycin had greater activity against A. vaginae, G. vaginalis, and Mobiluncus spp. compared to 5-nitroimidazoles	More than a third of the Prevotella spp. were resistant to clindamycin SEC has similar in vitro activity against a range of BVAB compared to MTZ or TDZ. It also spares vaginal lactobacilli (data not shown)
Li, 2020	10 clinical isolates of G. vaginalis	MTZ, clindamycin at planktonic and biofilm levels	Planktonic isolates had greater susceptibility (76.7% vs. 38.2%) and lower resistance (23.3% vs. 58.5%) to clindamycin vs. MTZ (p < 0.05 for both) In comparison to planktonic isolates, the MIC of MTZ was higher for biofilm-forming isolates, the resistance rate was 27.3%, and the MBEC was >128 µg/mL. The MIC of clindamycin was also higher for biofilm-forming isolates compared to planktonic isolates, the resistance rate was 27.3%, and the MBEC was 28.4 ± 6.50 µg/mL	Clindamycin may be a better treatment option than MTZ for G. vaginalis, as it exhibits relatively higher susceptibility and lower resistance rates in vitro

Abbreviations: MTZ = metronidazole; MIC = minimum inhibitory concentration; MBEC = minimum biofilm eradication concentration; BVAB = BV-associated bacteria; TDZ = tinidazole; SEC = secnidazole.