New possibilities of therapy bacterial vaginosis: experience an antibiotic used concurrently with a prebiotic in bacterial vaginosis


如何引用文章

全文:

开放存取 开放存取
受限制的访问 ##reader.subscriptionAccessGranted##
受限制的访问 订阅或者付费存取

详细

Objective. To evaluate the efficiency and safety of therapy for bacterial vaginosis (BV) with Lactogynal vaginal capsules and clindamycin vaginal cream 2%. Subjects and methods. Group 1 received clindamycin and Lactogynal for 7days, then only Lactogynal for 7days; Group 2 used clindamycin and Lactogynal for 7 days; Group 3 had clindamycin for 7 days, then Lactogynal for 7 days. After therapy, the patients were followed up for 15-24 days. Results. At 2 weeks after therapy, the clinical cure rates were 88.9% in Group 1, 86.4% in Group 2, and 87.0% in Group 3. The laboratory cure rates according to the Amsel criteria were 95.6, 93.2, and 93.5% in Groups 1, 2, and 3, respectively; those according to the Nugent criteria were 95.6, 90.9, and 93.5% in Groups 1, 2, 3. The PCR cure rates were 77.8, 61.4, and 69.6% in Groups 1, 2, and 3, respectively. The global assessment of clinical and laboratory efficiencies revealed that the total therapeutic cure rates were 66.7% in Group 1, 59.1% in Group 2, and 63.0% in Group 3. The therapy was proven to be no less effective in the study group (Group 1) than in the control group (Group 3). Conclusion. The trial showed that the regimen involving Lactogynal used concurrently with the antibiotic and that of sequential use of the former were comparably effective. The concurrent use of Lactogynal with antibacterial therapy to restore the normal vaginal microflora in the therapy of bacterial vaginosis can increase adherence to treatment, and, therefore, achieve its general effect.

全文:

受限制的访问

作者简介

Igor Manukhin

A.I. Evdokimov MGMSU

Email: katemanu@mail.ru
MD, Professor, Head of the Department of obstetrics and gynecology, Therapeutical Faculty

Vera Balan

Moscow regional Research Institute of Obstetrics and Gynecology

Email: balanmed@gmail.com
MD, Professor, Head of the Polyclinic Department

Yulia Dobrokhotova

N.I. Pirogov Russian National Research Medical University

Email: pr.dobrohotova@mail.ru
MD, Professor, Head of Department of Obstetrics and Gynecology, Faculty of General Medicine

Viktoriya Krutova

Kuban State Medical University of the Ministry of Health of the Russian Federation

Email: vik_krutova@yandex.ru
MD, Professor of the Department of obstetrics, gynecology and Perinatology

Flora Kutueva

Saint Petersburg State Pediatric Medical University Ministry of Health of the Russian Federation

Email: flora-kutueva@mail.ru
PhD, Honored Doctor of the Russian Federation, assistant of the Department of obstetrics and gynecology

Indira Sakhautdinova

FGBOU HE “Bashkir State Medical University” of the Ministry of Health of the Russian Federation

Email: 27@yandex.ru
MD, Professor, Head of the Department of obstetrics and gynecology No. 1

Natalia Tapilskaya

Saint Petersburg State Pediatric Medical University Ministry of Health of the Russian Federation

Email: tapnatalia@yandex.ru
MD, Professor of the Department of obstetrics and gynecology with the course of gynecology for children

Natalia Fedulova

Aurora Medi LLC

Email: fedulovaru1@rambler.ru
obstetrician-gynecologist

Lyudmila Chernyshova

JSC “Inheritors”

Email: 7251336@mail.ru
obstetrician-gynecologist, Deputy chief physician

参考

  1. Шейка матки, влагалище, вульва. Физиология, патология, кольпоскопия, эстетическая коррекция: руководство для практикующих врачей. Под ред. С.И. Роговской, Е.В. Липовой. М.: Издательство журнала StatusPraesens, 2014. 250 с
  2. Федеральные клинические рекомендации РОАГ «Диагностика и лечение заболеваний, сопровождающихся патологическими выделениями из половых путей женщин», 2019.
  3. Larsson P.G.,Platz Christensen J.J., Thejls H. et al. Incidence ofpelvic infammatory disease after firsttrimester legal abortion in women with bacterialvaginosis after treatment with etronidazole: a doubleblind, randomized study. Am. J. Obstet. Gynecol. 1992; 166 (1 Pt. 1): 100-103.
  4. Persson E., Bergstrom M., Larsson P.G. et al. Infections after hysterectomy. A prospective ationwide Swedish study. The study group on infectious diseases in obstetrics and gynecology within the Swedish Society of obstetrics and gynecology. Acta Obstet. Gynecol. Scand. 1996; 75: 757-761.
  5. Charonis G., Larsson P.G. Use of pH/whiff test or QuickVue Advanced pH and Amines test for the diagnosis of bacterial vaginosis and prevention of postabortion pelvic infammatory disease. Acta Obstet. Gynecol. Scand. 2006; 85: 837-843.
  6. Национальное руководство по гинекологии. Под ред. В.И. Кулакова и др. М.: ГЭОТАРМедиа, 2009. 1088 с. [National manual of obstetrics. Edited by V. I. Kulakov and others. M.: GEOTAR-Media, 2009. 1088 p. (in Russian)].
  7. Birnbaumer D.M., Anderegg C. Sexually transmitted diseases. J.A. Marx et al. (Eds.). Rosen’s Emergency Medicine: Concepts and Clinical Practice. 7th ed. Philadelphia. Pa: Mosby Elsevier, 2009.
  8. Atashili J., Poole C., Ndumbe P.M. et al. Bacterial vaginosis and HIV acquisition: a metaanalysis of published studies. AIDS. 2008; 22: 1493-1501.
  9. Chohan V.H., Baeten J., Benki S. et al. A prospective study of risk factors for herpes simplex virus Type 2 Acquisition among highrisk HIV1 Sero negative Kenyan Women. Sex Transm. Infect. 2009; 85: 489-492.
  10. van de Wijgert J.H., Morrison C.S., Cornelisse P.G. et al. Bacterial vaginosis and vaginal yeast, but not vaginal cleansing, increase HIV1 acquisition in African women. J. Acquir. Immune. Defc. Syndr. 2008; 48: 203-210.
  11. UN General Assembly Resolution A/RES/71/3, 5 October 2016, A/RES/71/3 (2016). Political declaration of the high-level meeting of the General Assembly on antimicrobial resistance.
  12. Mishra R.K., Segal E., Lipovsky A., Natan M., Banin E., Gedanken A. New life for an old antibiotic. ACS Appl. Mater. Interfaces. 2015; 7(13): 7324-33.
  13. David A. Eschenbach. Bacterial Vaginosis: Resistance, Recurrence, and/or Reinfection? Clinical Infectious Diseases. 2007; 44 (2): 220-221.
  14. Beigi R.H., Austin M.N., Meyn L.A. et al. Antimicrobial resistance associated with the treatment of bacterial vaginosis. Am J Obstet Gynecol. 2004; 191: 1124.
  15. Macklaim J.M., Clemente J.C., Knight R., Gloor G.B., Reid G. Changes in vaginal microbiota following antimicrobial and probiotic therapy. Microb. Ecol. Health Dis. 2015; 26: 277-99.
  16. Сгибнев А.В., Кремлева Е.А. Метаболиты нормальной микрофлоры влагалища повышают активность антибиотиков. Акушерство и гинеко логия. 2017; (3): 108-14. [Sgibnev A.V., Kremleva E.A. Metabolites of the normal vaginal microflora increase the activity of antibiotics. Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2017; (3): 108-14. (in Russian)].
  17. Sgibnev A., Kremleva E. Influence of hydrogen peroxide, lactic acid, and surfactants from vaginal lactobacilli on the antibiotic sensitivity of opportunistic bacteria. Probiotics and antimicrobial proteins. 2017; 9(2): 131-41.
  18. Савичева А.М., Рыбина Е.В. Исследование in vitro роста, размножения, антибиотикорезистентности, конкурентных взаимоотношений штамма Lactobacillus casei rhamnosus. Акушерство и гинекология. 2014; 7: 79-83. [Savicheva A.M., Rybina E.V. In vitro study of growth, reproduction, antibiotic resistance, and competitive relationships of the Lactobacillus casei rhamnosus strain. Obstetrics and gynecology. 2014; 7: 79-83 (in Russian)].
  19. Подзолкова Н.В., Созаева Л.Г., Иванычева И.Д., Пономарева И.В. Возможности одноэтапной терапии больных с бактериальным вагинозом (результаты многоцентрового открытого проспективного пилотного исследования). Российский вестник акушера-гинеколога. 2015; 3: 70-75. [Podzolkova N.V., Sosayeva L.G., Ivanycheva I.D., Ponomareva I.V. Possibilities of one-stage therapy of patients with bacterial vaginosis (results of a multicenter open prospective pilot study). Russian Bulletin of obstetrician-gynecologist. 2015; 3: 70-75. (in Russian)].
  20. Ляшенко А.А., Свищева М.С. Методология расчета объема выборки в сравнительных контролируемых клинических исследованиях с «неменьшей эффективностью»: сравнение двух пропорций в параллельных группах. Качественная клиническая практика. 2014; 3: 24-28. [Lyashenko A.A., Svishcheva M.S. Methodology for calculating the sample size in comparative controlled clinical trials with “no less effectiveness”: comparison of two proportions in parallel groups. Qualitative clinical practice. 2014; 3: 24-28. (in Russian)].
  21. Committee for proprietary medicinal products (CPMP) (2004). Points to consider on the choice of non-inferiority margin.
  22. Dunnett C.W., Gent M. Signifcance testing to establish equivalence between treatments, with special reference to data in the form of 2X2 tables. Biometrics. 197; 33(4): 593-602.
  23. Borgdof H., Armstrong S.D., Tytgat H.L. et al. Unique insights in the cervicovaginal Lactobacillus iners and L. crispatus Proteomes and their associations with microbiota dysbiosis. PLoS ONE. 2016; 11: e0150767. doi: 10.1371/journal.pone.0150767.
  24. Petricevic L., Witt A. The role of Lactobacillus casei rhamnosus Lcr35 in restoring the normal vaginal flora after antibiotic treatment of bacterial vaginosis. BJOG. 2008; 115: 1369-1374.

补充文件

附件文件
动作
1. JATS XML
下载
##common.cookie##