COMPARATIVE ANALYSIS OF THE EFFICIENCY AND SAFETY OF PARALLEL OR SEQUENTIAL COMBINATION OF METRONIDAZOLE WITH LACTIC ACID AND A TWO-STAGE REGIMEN INCLUDING METRONIDAZOLE PLUS A PROBIOTIC: A MULTICENTER RANDOMIZED CONTROLLED STUDY


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Objective. To investigate the efficiency and safety of two dosage regimens of lactic acid in combination with metronidazole versus a conventional two-stage regimen consisting of metronidazole + a probiotic. Subjects and methods. 140patients with bacterial vaginosis (BV) were randomized into 3 groups: 1) 40patients received vaginally metronidazole and lactic acid at an interval of 12 hours for 10 days; 2) the patients took sequentially metronidazole (for 10 days) and lactic acid (for 10 days) (the treatment cycle was 20 days); 3) those who had a 20-day total sequential therapy involving metronidazole for 10 days and then a probiotic for 10 days. Therapeutic effectiveness was evaluated using the Amsel criteria and real-time PCR results. The data were statistically processed using Statistica 10.0. Results. There were statistically significant differences in the basic criteria: a reduction in leucorrhoea, amine odor, and key cell counts and vaginal pH restoration in favor of the patients treated with lactic acid versus those used the probiotic. There were also significant better results in reducing the titer of BV-associated microorganisms and the growth of lactobacilli in the lactic acid groups. Conclusion. The parallel or sequential use of a combination of metronidazole and lactic acid as vaginal suppositories is a more effective treatment for BV than that of a combination of metronidazole and the probiotic.

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Sobre autores

Evgeniy Kira

N.I. Pirogov National Medical and Surgical Center, Ministry of Health of Russia

Email: profkira33@gmail.com
Doctor of Medicine, professor, Chief Obstetrician & Gynecologist, Head of Department of Female Disease and Reproductive Health Moscow 105203, Nizhnyaya Pervomayskaya str. 70, Russia

Oleg Pekarev

Novosibirsk State Medical Academy

Email: ogpekarev@perinatalcenter.nsk.ru
Doctor of Medicine, professor Novosibirsk 630091, Krasny pr. 52, Russia

Oleg Molchanov

S.M. Kirov Military Medical Academy

Doctor of Medicine, professor, Head of the Department of assisted reproductive technology Saint Petersburg 190044, Clinicheskaya str. 4, Russia

Larisa Maltseva

Kazan State Medical Academy

Email: laramalc@mail.ru
Doctor of Medicine, professor, Head of the Department of Obstetrics and Gynecology №1 Kazan 420015, Mushtari str. 11, Russia

Viktor Aksenenko

Stavropol State Medical University

Email: aksenenko.vic@yandex.ru
Doctor of Medicine, professor, Head of the Department of Obstetrics and Gynecology Stavropol 355017, Mira str. 310, Russia

Marina Selikhova

Volgograd State Medical University

Email: selichovamarina@yandex.ru
Doctor of Medicine, professor, Department of Obstetrics and Gynecology Volgograd 400131, Pavshikh bortstov sq. 1, Russia

Olga Letyaeva

South Ural State Medical University

Email: olga-letyaeva@yandex.ru
Doctor of Medicine, professor, Department of dermatology Chelyabinsk 454092, Vorovskogo str. 64, Russia

Nikolai Minaev

Voronezh State Medical University

Email: mnn@vmail.ru
Doctor of Medicine, professor, Head of the Department of Obstetrics and Gynecology Voronezh 394036, Studencheskaya str. 10, Russia

N. Korshakova

N.I. Pirogov National Medical and Surgical Center, Ministry of Health of Russia

Moscow 105203, Nizhnyaya Pervomayskaya str. 70, Russia

Bibliografia

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