Improved approaches in the treatment of complicated bacterial vaginosis and vulvovaginal candidiasis
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01.01.2018 |
Strizhakov A.
Ignatko I.
Churganova A.
Bogacheva N.
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Akusherstvo i Ginekologiya (Russian Federation) |
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© Bionika Media Ltd. Objective. To conduct a comparative analysis of the effectiveness of an improved imidazole derivative (2% clotrimazole cream) as part of complex therapy with standard treatment regimens for the development of bacterial vaginosis and vulvovaginal candidiasis. Materials and methods. The study included 90 women who had combinations of Atopobium vaginae, Gardnerella vaginalis and Candida krusei. These pathogens caused not only the development of an infectious process in the lower part of the urogenital tract, but also its complicated course. Results. The study showed that the use of the improved imidazole derivative (2% clotrimazole cream) could arrest the main symptoms of the disease after the first use. The drug is highly effective against difficult-to-cultivate pathogens of bacterial vaginosis and Candida non-albicans, and also does not adversely affect the amount of lactobacilli in vaginal biocenosis. Conclusion. The experience of using the improved imidazole derivative shows that the drug is no less effective in inflammatory diseases of the lower parts of the urogenital tract than its counterparts. Its purpose is appropriate in the complex therapy of complicated bacterial vaginosis and vulvovaginal candidiasis.
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Bacterial vaginosis and vulvovaginal candidiasis
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01.01.2018 |
Kuznetsova I.
Chilova R.
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Akusherstvo i Ginekologiya (Russian Federation) |
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© Bionika Media Ltd. Objective. To carry out a systems analysis of the data available in the current literature on the pathogenesis, therapy, and prevention of vaginal infections caused by the pathogens of bacterial vaginosis (BV) and vulvovaginal candidiasis (VVC). Material and methods. The review includes the data of foreign and Russian articles published in the past 10 years and found in Pubmed on this topic. Results. The paper highlights the main pathways of pathogenesis and the causes of recurrent vaginal coinfection. It describes methods for the treatment of women with BV and VVC and presents the optimal therapy and prevention schemes for recurrent vaginal infectious diseases, which have evidence-based effectiveness. Conclusion. The features of a microbial portrait and immune status predispose to recurrent BV and VVC, the presence of which results in coinfection. The cause of the latter is also repeated therapy for recurrent monoinfection. First-line therapy for BV is recognized to include metronidazole and clindamycin; the advantages of the latter are a wider spectrum of activity against the microorganisms that are difficult to identify. To treat coinfection and to prevent VVC in patients with BV, it is advisable to use fluconazole that also remains a first-line treatment option for vaginal infection caused by Candida albicans.
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Vulvovaginal candidiasis during of pregnancy (Features of the therapy in the first trimester)
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01.01.2018 |
Borovikov I.
Kutsenko R.
Ermolaeva A.
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Akusherstvo i Ginekologiya (Russian Federation) |
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© Bionika Media Ltd. Objective. Evaluation method of therapy for pregnant women, with vulvovaginal candidiasis, with a combination of oral and intravaginal introduction polyene macrolide – natamycin. Subjects and methods. The results of treatment in 110 pregnant women, patients with invasive vulvovaginal 10-12 weeks gestation: group 1 (n = 55) therapy with natamycin intravaginal at a dose of 100 mg 1 times daily for 6 days; Group 2 (n = 55) had combined treatment natamicinum intravaginal at a dose of 100 mg 1 times daily for 6 days + natamicinum peroral at a dose of 100 mg 4 times daily for 10 days. Direct microscopy, measuring the pH of the vagina, cultural method was using. Results. Found that the combined intake of natamicinum (oral and intravaginal reception) increases the clinical efficacy of therapy vulvovaginal candidiasis in 1.7 ± 0.12, and microbiological -1.3 ± 0.1 times. Conclusion. Application of combined therapy antimycotics reasonable etiologically (simultaneous vaginal disinfection and colon) with polyene macrolides natamycin has the fewest side effects, absence of adverse effects on the fetus, and helps improve clinical microbiological efficacy of treatment in patients vulvovaginal invasive.
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Low–grade intraepithelial cervical lesions in pregnant women with hpv and vaginal biocenotic disorders
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01.01.2018 |
Bebneva T.
Dikke G.
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Akusherstvo i Ginekologiya (Russian Federation) |
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© 2018, Bionika Media Ltd.. All rights reserved. The authors have established a relationship between intraepithelial cervical lesions and vaginal biocenotic disorders in pregnant women with human papillomavirus (HPV) infection and determined their management tactics. The HPV–positive pregnant women have a high incidence of vaginal dysbiosis (38.7%) that is, in most of them, characterized by co–infection (65%), mainly by anaerobic and aerobic infections (44.1%). High-rate HPV in the pregnant women is associated with bacterial vaginosis, mixed dysbiosis, and their recurrences and with the frequency of atypical squamous cells of undetermined significance (ASCUS) and low-grade squamous intraepithelial lesions (LSIL) in the presence of an inflammatory response. Restoring the normal microflora contributes to the disappearance of the inflammatory response and to the reduction of ASCUS. Therapy for dysbiosis does not change the rate of LSIL at 3-month follow-up.
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Current ideas on vulvovaginal candidiasis
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01.01.2018 |
Kulikov I.
Ovsyannikova T.
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Akusherstvo i Ginekologiya (Russian Federation) |
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© Bionika Media Ltd. The article presents an explanation of the relevance of using regimens incorporating highly effective antimycotics in modern society, which is dictated by the lifestyle of large cities and the modern generation. After the symptoms of the disease disappear, many patients discontinue a prescribed drug treatment regimen on their own, interrupting the full cycle, which can lead to recurrences and unresponsiveness to treatment in the future.
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