Study of the effect of a combination of antimicrobial agents and prednisolone in the form of prednisolone sodium phosphate on the microecological state of the lower female genitalia
Objective. To evaluate the effect of a combination of antimicrobial agents and prednisolone on the state of mucosal immunity, the severity of inflammation, the growth and susceptibility of the vaginal microflora to antibiotics.Kremleva E.A., Sgibnev A.V., Shchetinina Yu.S.
Subjects and methods. Eighty patients with vaginitis received Elzhina®. Vaginal microflora and levels of IL-1β, IL-6, IL-8, TNFα, PGE2α, lactoferrin, and sIgA were determined before and after therapy. The effect of prednisolone on the growth and antibiotic susceptibility of opportunistic microorganisms and lactobacilli was studied in vitro.
Results. The high values of leukocyte-epithelial index (LEI), cytokines, PGE2α and the low levels of lactoferrin and sIgA created barriers to treatment. Therapy reduced inflammation and normalized the state of mucosal immunity. Prednisolone stimulated the growth of S. aureus and E. coli and suppressed Candida spp. and lactobacilli, respectively, by increasing and decreasing their susceptibility to antibiotics.
Conclusion. The efficiency of using a combination of antimicrobial agents and prednisolone is determined not only by antimicrobial activity, but also by the effect on the degree of an inflammatory response, on the state of mucosal immunity and on the susceptibility of microorganisms to antibiotics.
Keywords
antimicrobial therapy
vaginitis
lactobacilli
prednisolone (prednisolone in the form of sodium phosphate)
trichomoniasis
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Received 01.11.2019
Accepted 04.11.2019
About the Authors
Elena A. Kremleva, MD, leading researcher, Laboratory for the study of the mechanisms of formation microbiocenoses of humans; Institute of Cellular and Intracellular Symbiosis, Ural Branch of RAS, 460000, Orenburg, Pionerskaja Street, b. 11, of.107; Phone: +7(3532)770512; Professor, Department of Obstetrics and Gynecology Orenburg State Medical University, Ministry of Healthcare of the Russian Federation; 460000, Sovetskaya Street, b. 6, Phone: +7(3532)310201; ORCID 0000-0003-1916-784X e-mail: kremlena1@mail.ruAndrey V. Sgibnev, doctor of Biology, Head of the laboratory for the study of the mechanisms of formation microbiocenoses of humans; Institute of Cellular and Intracellular Symbiosis, Ural Branch of RAS, 460000, Orenburg, Pionerskaja Street, b. 11, of.107; Phone: 8(3532)770512; Professor, Department of Biological Chemistry Orenburg State Medical University, Ministry of Healthcare of the Russian Federation; 460000, Sovetskaya Street, b. 6,
Phone: +7(3532)310201 ORCID ID: 0000-0003-1866-1678; e-mail: sgibnew72@yandex.ru
Yuliya S. Shchetinina, PhD, Associate Professor, Department of Obstetrics and Gynecology Orenburg State Medical University, Ministry of Healthcare of the Russian Federation; 460000, Sovetskaya Street, b. 6, Phone: +7(3532)310201; e-mail: koto-yuliya@yandex.ru
Kremleva E.A., Sgibnev A.V., Shchetinina Yu.S. Study of the effect of a combination of antimicrobial agents and prednisolone in the form of prednisolone sodium phosphate on the microecological state of the lower female genitalia.
Akusherstvo i Ginekologiya/ Obstetrics and gynecology. 2019; 11: 209-14.(In Russian).
https://dx.doi.org/10.18565/aig.2019.11.209-214
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