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<article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns:ali="http://www.niso.org/schemas/ali/1.0/" article-type="research-article" dtd-version="1.2" xml:lang="en"><front><journal-meta><journal-id journal-id-type="publisher-id">Obstetrics and Gynecology</journal-id><journal-title-group><journal-title xml:lang="en">Obstetrics and Gynecology</journal-title><trans-title-group xml:lang="ru"><trans-title>Акушерство и гинекология</trans-title></trans-title-group></journal-title-group><issn publication-format="print">0300-9092</issn><issn publication-format="electronic">2412-5679</issn><publisher><publisher-name xml:lang="en">Bionika Media</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="publisher-id">691952</article-id><article-id pub-id-type="doi">10.18565/aig.2025.236</article-id><article-categories><subj-group subj-group-type="toc-heading" xml:lang="en"><subject>Guidelines for the Practitioner</subject></subj-group><subj-group subj-group-type="toc-heading" xml:lang="ru"><subject>В помощь практическому врачу</subject></subj-group><subj-group subj-group-type="article-type"><subject>Research Article</subject></subj-group></article-categories><title-group><article-title xml:lang="en">The role of josamycin in the treatment of the lower genital tract inflammation in women</article-title><trans-title-group xml:lang="ru"><trans-title>Место джозамицина в лечении воспалительных заболеваний нижних отделов полового тракта у женщин</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-4581-6295</contrib-id><name-alternatives><name xml:lang="en"><surname>Apolikhina</surname><given-names>Inna A.</given-names></name><name xml:lang="ru"><surname>Аполихина</surname><given-names>Инна Анатольевна</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>Dr. Med. Sci., Professor, Head of the Department of Aesthetic Gynecology and Rehabilitation, Professor at the Department of Obstetrics, Gynecology, Perinatology, and Reproductology, Institute of Professional Education</p></bio><bio xml:lang="ru"><p>д.м.н., профессор, заведующая отделением эстетической гинекологии и реабилитации, профессор кафедры акушерства, гинекологии, перинатологии и репродуктологии Института профессионального образования</p></bio><email>apolikhina@inbox.ru</email><xref ref-type="aff" rid="aff1"/><xref ref-type="aff" rid="aff2"/></contrib><contrib contrib-type="author"><name-alternatives><name xml:lang="en"><surname>Tarnaeva</surname><given-names>Liana A.</given-names></name><name xml:lang="ru"><surname>Тарнаева</surname><given-names>Лиана Александровна</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>obstetrician-gynecologist, PhD student at the Department of Aesthetic Gynecology and Rehabilitation</p></bio><bio xml:lang="ru"><p>врач акушер-гинеколог, аспирант</p></bio><email>li.tarnaeva@ya.ru</email><xref ref-type="aff" rid="aff1"/></contrib></contrib-group><aff-alternatives id="aff1"><aff><institution xml:lang="en">Academician V.I. Kulakov National Medical Research Centre for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia</institution></aff><aff><institution xml:lang="ru">ФГБУ «Национальный медицинский исследовательский центр акушерства, гинекологии и перинатологии имени академика В.И. Кулакова» Минздрава России</institution></aff></aff-alternatives><aff-alternatives id="aff2"><aff><institution xml:lang="en">I.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of Russia</institution></aff><aff><institution xml:lang="ru">ФГАОУ ВО «Первый Московский государственный медицинский университет имени И.М. Сеченова Минздрава России (Сеченовский Университет)</institution></aff></aff-alternatives><pub-date date-type="pub" iso-8601-date="2025-10-09" publication-format="electronic"><day>09</day><month>10</month><year>2025</year></pub-date><issue>9</issue><issue-title xml:lang="en"/><issue-title xml:lang="ru"/><fpage>168</fpage><lpage>174</lpage><history><date date-type="received" iso-8601-date="2025-10-04"><day>04</day><month>10</month><year>2025</year></date><date date-type="accepted" iso-8601-date="2025-10-04"><day>04</day><month>10</month><year>2025</year></date></history><permissions><copyright-statement xml:lang="en">Copyright ©; 2025, Bionika Media</copyright-statement><copyright-statement xml:lang="ru">Copyright ©; 2025, ООО «Бионика Медиа»</copyright-statement><copyright-year>2025</copyright-year><copyright-holder xml:lang="en">Bionika Media</copyright-holder><copyright-holder xml:lang="ru">ООО «Бионика Медиа»</copyright-holder></permissions><self-uri xlink:href="https://journals.eco-vector.com/0300-9092/article/view/691952">https://journals.eco-vector.com/0300-9092/article/view/691952</self-uri><abstract xml:lang="en"><p>Inflammatory diseases of the lower female genital tract, including cervicitis and vaginitis, are among the most common causes for seeking medical attention from a gynecologist. These conditions can lead to severe complications, such as pelvic inflammatory diseases, infertility, miscarriage, and cervical neoplasia. These diseases are multifactorial in their origin: the causative agents are aerobic and anaerobic bacteria, as well as intracellular pathogens such as Chlamydia trachomatis, Mycoplasma genitalium, and Ureaplasma spp. In recent years, there has been a significant increase in antibiotic resistance, especially in intracellular microorganisms. This resistance complicates therapy and leads to the need for alternative antibacterial strategies.</p> <p>Josamycin is one of the few macrolides that have high activity against M. genitalium, Ureaplasma spp. and M. hominis. It also has a favorable safety profile and can be used by pregnant women. The medication has been proven effective in treating chlamydia, mycoplasma, and mixed infections of the vagina and cervix, making it a popular choice for use in daily outpatient care. In 2025, the Russian generic of josamycin, Josafen, was registered and entered the pharmaceutical market. It is identical in all respects to the original medication and it is available in the form of a dispersible tablet. This form increases treatment adherence, provides predictable therapeutic effects, and reduces the risk of adverse reactions.</p> <p><bold>Conclusion:</bold> Josamycin (Josafen) plays an important role in modern gynecological practice as an effective and safe treatment for nonspecific cervicitis and vaginitis in reproductive-aged women and pregnant women as well. Its use makes it possible to increase the effectiveness of therapy, reduce the risk of relapses and improve reproductive outcomes.</p></abstract><trans-abstract xml:lang="ru"><p>Воспалительные заболевания нижних отделов женского полового тракта, включая цервицит и вагинит, являются одними из наиболее распространенных причин обращаемости к врачу-гинекологу и ассоциированы с серьезными осложнениями, такими как воспалительные заболевания органов малого таза, бесплодие, невынашивание беременности и неоплазии шейки матки. Эти патологии имеют полиэтиологическую природу: возбудителями выступают аэробные и анаэробные микроорганизмы, а также внутриклеточные патогены, в частности Chlamydia trachomatis, Mycoplasma genitalium и Ureaplasma spp. В последние годы отмечается значительный рост антибиотикорезистентности, особенно у внутриклеточных микроорганизмов, что осложняет терапию и требует поиска альтернативных антибактериальных стратегий.</p> <p>Джозамицин остается одним из немногих макролидов, обладающих высокой активностью в отношении M. genitalium, Ureaplasma spp. и M. hominis, а также благоприятным профилем безопасности, включая возможность применения у беременных. Его клиническая эффективность подтверждена исследованиями при хламидийных, микоплазменных и смешанных инфекциях влагалища и шейки матки, что делает препарат востребованным в повседневной амбулаторной практике. В 2025 г. на российском фармацевтическом рынке зарегистрирован отечественный дженерик джозамицина – Джозафен, полностью биоэквивалентный оригинальному препарату и выпускающийся в диспергируемой форме. Такая форма повышает приверженность лечению, обеспечивает предсказуемое терапевтическое действие и снижает риск побочных реакций.</p> <p><bold>Заключение: </bold>Таким образом, джозамицин (Джозафен) занимает важное место в современной гинекологической практике как эффективный и безопасный препарат для лечения неспецифического цервицита и вагинита, в том числе у женщин репродуктивного возраста и беременных. Его использование позволяет повысить эффективность терапии, снизить риск рецидивов и улучшить репродуктивные исходы.</p></trans-abstract><kwd-group xml:lang="en"><kwd>josamycin</kwd><kwd>Josafen</kwd><kwd>vaginitis</kwd><kwd>cervicitis</kwd><kwd>macrolides</kwd><kwd>antibiotic resistance</kwd><kwd>clinical efficacy</kwd><kwd>safety</kwd></kwd-group><kwd-group xml:lang="ru"><kwd>джозамицин</kwd><kwd>Джозафен</kwd><kwd>вагинит</kwd><kwd>цервицит</kwd><kwd>макролиды</kwd><kwd>антибиотикорезистентность</kwd><kwd>клиническая эффективность</kwd><kwd>безопасность</kwd></kwd-group><funding-group/></article-meta></front><body></body><back><ref-list><ref id="B1"><label>1.</label><mixed-citation>Groetsch S. Cervicitis. Clinics in family practice. 2025; 7(1): 43-56. https://dx.doi.org/10.1016/j.cfp.2005.01.002</mixed-citation></ref><ref id="B2"><label>2.</label><mixed-citation>Vodstrcil L.A., Plummer E.L., Nguyen T.V.., Fairley CK., Chow E.P.F., Phillips T.R. et al. 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