Activated glycyrrhizic acid in the combination treatment of patients with vaginitis and dysbiosis: results of a multicenter study

Objective: To study the effect of 0.1% activated glycyrrhizic acid spray on the relief of vulvar discomfort and pathological leucorrhoea in women with nonspecific (aerobic), vulvovaginal candidiasis and bacterial vaginosis.

Materials and methods: The study was conducted under the supervision of the principal investigator with the participation of outpatient healthcare facilities providing obstetric and gynecological care in the cities: Moscow, Saint Petersburg, Voronezh, Belgorod, Krasnodar, Rostov-on-Don, Stavropol, Yekaterinburg, Chelyabinsk, Ufa, Novosibirsk, Krasnoyarsk, Irkutsk, Samara, Saratov, Kazan, and Nizhny Novgorod. The investigation enrolled 8,249 patients aged 18 to 45 years who complained of pathological vaginal discharge, discomfort in the external genital area with a clinical diagnosis of nonspecific (aerobic) vaginitis, vulvovaginal candidiasis, or bacterial vaginosis. All the patients underwent a comprehensive examination, including a physical and gynecological examination, bacterioscopy of vaginal smears, and comprehensive quantitative assessment of the vaginal microflora using a real-time polymerase chain reaction assay. All the patients were prescribed etiotropic therapy depending on the pathogen and clinical diagnosis at the discretion of an attending physician, by adding 0.1% activated glycyrrhizic acid (Epigen Intim) spray.

Results: The combination therapy resulted in a reduction of discomfort symptoms, such as itching (from 1.45 to 0.35 scores), burning (from 1.44 to 0.35 scores), unpleasant odor (from 1.31 to 0.51 scores), profuse discharge (from 1.8 to 0.30 scores), vulvar and vaginal mucosal dryness (from 0.44 to 0.16 scores), painful urination (from 0.37 to 0.14 scores), and dyspareunia (from 0.71 to 0.16 scores). The nature of discharge and its volume were stated to normalize (the proportion of patients with an abnormal discharge volume decreased from 3,812/8,249 (46.6%) to 101/8,249 (1.1%)).

Conclusion: When included in the combination treatment of patients with clinical manifestations of aerobic vaginitis, vulvovaginal candidiasis, and bacterial vaginosis, the drug based on 0.1% activated glycyrrhizic acid spray for local and topical application was found to relieve (cease) complaints of pathological vaginal discharge and vulvovaginal discomfort and to be safe and well tolerated.