A comprehensive approach to treating chronic recurrent uncomplicated cystitis during pregnancy
Objective: To evaluate the efficiency of combination therapy for chronic recurrent uncomplicated cystitis during pregnancy.Tyutyunnik V.L., Mikhailova O.I., Kan N.E., Mirzabekova D.D.
Materials and methods: The investigation enrolled 50 pregnant women with chronic recurrent uncomplicated cystitis in the second or third trimester. There were two equal formed groups: 1) a study group that included 25 women who received combination treatment with an antibiotic and an immunomodulatory agent; 2) a comparison group that consisted of 25 women who took an antibiotic only. The efficiency of different treatment regimens for chronic recurrent uncomplicated cystitis was evaluated, by analyzing laboratory data, assessing the Acute Cystitis Symptom Score (ACSS) questionnaire, determining the immune status, and analyzing the characteristics of the course of labor and perinatal outcomes.
Results: Therapy with an antibiotic in combination with the immunomodulatory agent Superlymph showed the greatest efficiency in treating chronic recurrent uncomplicated cystitis. In the study group, leukocytosis during a urinalysis and the growth of pathogens during microscopic examination were most significantly decreased; positive changes in the indicators of innate immunity were more pronounced; the period between exacerbations of cystitis was much longer and the duration of relapses was shorter; and the quality of life became substantially better, as shown by the ACSS questionnaire. In addition, this patient cohort was recorded to have the most favorable obstetric and perinatal outcomes.
Conclusion: The immunomodulatory agent Superlymph in combination with an antibiotic can be recommended for use in the therapy of chronic recurrent uncomplicated cystitis in the second or third trimester of pregnancy, which significantly increases the efficiency of the performed treatment.
Keywords
cystitis
pregnancy
fosfomycin
immunomodulatory therapy
Superlymph
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Received 19.07.2022
Accepted 26.07.2022
About the Authors
Victor L. Tyutyunnik, Professor, MD, PhD, Leading Researcher of Research and Development Service, Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology Ministry of Health of Russia, +7(903)969-50-41, tioutiounnik@mail.ru, Researcher ID: B-2364-2015, SPIN-код: 1963-1359,Authors ID: 213217, Scopus Author ID: 56190621500, https://orcid.org/0000-0002-5830-5099, 117997, Russia, Moscow, Ac. Oparina str., 4.
Olga I. Mikhailova, PhD, Researcher, 2 Maternity Department, Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia, +7(926)564-68-13, omikhaylova@gmail.com, https://orcid.org/0000-0001-7569-8704, 117997, Russia, Moscow, Ac. Oparina str., 4.
Natalia E. Kan, Professor, MD, PhD, Deputy Director of Science, Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology Ministry of Health of Russia, +7(926)220-86-55, kan-med@mail.ru, Researcher ID: B-2370-2015, SPIN-код: 5378-8437, Authors ID: 624900, Scopus Author ID: 57008835600, https://orcid.org/0000-0001-5087-5946, 117997, Russia, Moscow, Ac. Oparina str., 4.
Dzhamilia D. Mirzabekova, graduate student, Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology Ministry of Health of Russia, +7(906)110-51-13, +7(920)984-94-07, Jamilya1705@yandex.ru, https://orcid.org/0000-0002-2391-3334, 117997, Russia, Moscow, Ac. Oparina str., 4.
Authors' contributions: Tyutyunnik V.L., Mikhailova O.I., Kan N.E., Mirzabekova D.D. – developing the design of the investigation, obtaining the data to be analyzed, review of publications on the topic of the article, statistical analysis of the findings, writing the text of the manuscript.
Conflicts of interest: The authors declare that there are no possible conflicts of interest.
Funding: The investigation has not been sponsored.
Ethical Approval: The investigation has been approved by the Ethics Committee of the V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia.
Patient Consent for Publication: All patients provided informed consent for the publication of their data.
Authors' Data Sharing Statement: The data supporting the findings of this study are available on request from the corresponding author after approval from the principal investigator.
For citation: Tyutyunnik V.L., Mikhailova O.I., Kan N.E., Mirzabekova D.D.
A comprehensive approach to treating chronic recurrent uncomplicated cystitis during pregnancy.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2022; 8: 124-130 (in Russian)
https://dx.doi.org/10.18565/aig.2022.8.124-130
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