Genitourinary infections in women: new opportunities for effective combined therapy

Khashukoeva A.Z., Khlynova S.A., Kerchelaeva S.B.

N.I. Pirogov Russian National Research Medical University, Moscow, Russia
Urogenital tract infections remain one of the urgent problems of obstetrics and gynecology due to their negative impact on reproduction, the course of pregnancy, the fetus and newborn. The article gives treatment regimens for vulvovaginal candidiasis, urogenital Chlamydia infection, and acute uncomplicated cystitis, which can effectively eliminate the pathogen and minimize side effects. Diagnostic and treatment methods are described in accordance with international protocols and Russian guidelines.

Keywords

vulvovaginal candidiasis
urogenital Chlamydia infection
genitourinary infection
acute uncomplicated cystitis
clotrimazole
roxithromycin
fosfomycin trometamol

References

  1. Sherrard J., Wilson J., Donders G., Mendling W., Jensen J.S. 2018 European (IUSTI/WHO) International Union against sexually transmitted infections (IUSTI) World Health Organisation (WHO) guideline on the management of vaginal discharge. Int J STD AIDS. 2018; 29(13): 1258-72. doi: 10.1177/0956462418785451
  2. Freynhagen R., Baron R., Gockel U., Tolle T. Pain DETECT: a new screening questionnaire to detect neropathic components in patients with back pain. Curr. Med. Res. Opin. 2006; (22): 1911-20. DOI: 10.1185/030079906X132488
  3. Ефремов А.В., Трунов А.Н., Трунова Л.А., Тихонова О.В. Патогенетические принципы диагностики и лечения обострений хронических инфекционно-воспалительных заболеваний придатков матки. Бюл. Сиб. отделения Рос. АМН. 2008; 21(1): 91-95. [Efremov A.V., Trunov A.N., Trunova L.A., Tihonova O.V. Patogeneticheskie principy diagnostiki i lechenija obostrenij hronicheskih infekcionno-vospalitel’nyh zabolevanij pridatkov matki. Bjul. Sib. Otdelenija Ros. AMN. 2008; 21(1): 91-95. (in Russian)]. eLIBRARY ID: 23431382
  4. Sobel J.D., Subramanian C., Foxman B., Fairfax M., et al. Mixed vaginitis-more than coinfections and with therapeutic implication. Curr. Infect. Dis. Rep. 2013; 15(2): 104-108. doi: 10.1007/s11908-013-0325-5
  5. Серова О.Ф., Зароченцева Н.В., Меньшикова Н.С. Иммунотропная терапия урогенитальных инфекций у беременных. АГ-инфо. 2007; 2: 12-16. [Serova O.F., Zarochentseva N.V., Men’shikova N.S. Immunotropnaja terapija urogenital’nyh infekcij u beremennyh. AG-info. 2007; 2: 12-16.(in Russian)].
  6. Репин И.В., Хлынова С.А., Черняева Е.В. Опыт применения препаратов интерферона в лечении хронических урогенитальных инфекций у женщин. Доктор.ру. 2014; 1(5): 33-41. [Repin I.V., Khlynova S.A., Tchernyaeva E.V. Chronic Urinary Tract Infections in Women: Treatment Experience with Interferon Products.Doctor.Ru. 2014; 1(5): 33-41. (in Russian)].
  7. Мирзабалаева А.К., Климко Н.Н. Диагностика и лечение кандидоза половых органов у женщин, девочек и подростков: Учебное пособие. СПб.: СПбМАПО, 2009. 58 с. [Mirzabalaeva A.K., Klimko N.N. Diagnosis and treatment of genital candidiasis in women, girls and adolescents: a Training manual. SPb .: SPbMAPO, 2009.58 s. (in Russian)].
  8. Klimko N., Kozlova Y., Khostelidi S., Shadrivova O, Borzova Y., Burygina E., Vasilieva N., Denning D.W. The burden of serious fungal diseases in Russia. Mycoses. 2015; 58(Suppl): S58-S62. doi:10.1111/myc.12388
  9. Sobel J.D. Recurrent vulvovaginal candidiasis. Am J Obstet Gynecol. 2016; 214: 15-21. doi: 10.1016/j.ajog.2015.06.067
  10. Powell A.M., Nyirjesy P. Recurrent vulvovaginitis. Best Pract Res Clin Obstet Gynaecol. 2014; 28: 967. https://doi.org/10.1016/j.bpobgyn.2014.07.006
  11. Workowski K.A., Bolan G.A.; Centers for Disease Control and Prevention. CDC Sexually transmitted diseases treatment guidelines. MMWR Recomm Rep. 2015; 64(RR-03):1-137. PMCID: PMC5885289
  12. Sherrard J., Wilson J., Donders G., et al. European (IUSTI/WHO) International Union against sexually transmitted infections (IUSTI) World Health Organisation (WHO) guideline on the management of vaginal discharge. Int J STD AIDS. 2018; 29(13): 1258-72. doi: 10.1177/0956462418785451
  13. Land J.A., Van Bergen J.E.A.M. Morre S.A., Postma M.J. Epidemiology of Clamydia trachomatis infection in women and the costeffectiveness of screening. Hum Reprod Update. 2010; 16(2): 189-204. doi: 10.1093/humupd/dmp035
  14. WHO. Prevention and control of sexually transmitted infections: draft global strstegy, 2006. http:/www.who.int/reproductive-health/docs/stis_strategy.pdf
  15. Struble K., Jackson R.L., Tolan Jr. R.W., et al. Chlamydial genitourinary infections//www.emedicine.medscape.com/article/214823-overview.
  16. Макаров О.В., Алешкин В.А., Савченко Т.Н., ред. Инфекции в акушерстве и гинекологии. М.: МЕДпресс-информ, 2009. 464 с [Makarov O.V., Aleshkin V.A., Savchenko T.N., ed. Infections in obstetrics and gynecology. M.: MEDpress-inform, 2009.446 s. (in Russian)].
  17. Mount S., Mead P., Cooper K. Chlamydia trachomatis in the endometrium: can surgical pathologists identify plasma cells? Adv Anat Pathol. 2001; (8): 327-329. DOI: 10.1097/00125480-200111000-00002
  18. Van Schalkwyk J., Yudin M.H. Infectious Disease Committee. Vulvovaginitis: screening for and management of trichomoniasis, vulvovaginal candidiasis, and bacterial vaginosis. J Obstet Gynaecol Can. 2015; 37(3): 266-74. doi: 10.1016/S1701-2163(15)30316-9.
  19. Gaydos C.A., Beqaj S., Schwebke J.R., et al. Clinical Validation of a Test for the Diagnosis of Vaginitis. Obstet Gynecol. 2017; 130(1): 181. doi: 10.1097/AOG.0000000000002090
  20. Перепанова Т.С. Неосложненная инфекция мочевых путей. Гинекология. 2006; 8(2): 8-10. [Perepanova T.S. Neoslozhnennaja infekcija mochevyh putej. Ginekologija. 2006; 02: 8-10. (in Russian)].
  21. Бондаренко К.Р., Доброхотова Ю.Э. Современные аспекты лечения отдельных урогенитальных инфекций при беременности. РМЖ. Мать и дитя. 2019; 2(3): 168-172. [Bondarenko K.R., Dobrokhotova Yu.E. Current treatment modalities for certain urogenital infections in pregnancy. Russian Journal of Woman and Child Health. 2019; 2(3): 168-172. (in Russian)]. DOI: 10.32364/2618-8430-2019-2-3-168-172
  22. Yan L., Jin Y, Hang H, Yan B. The assotiation between urinary tract infection during pregnancy and preeclampsia: A meta-analysis. Medicine (Baltimore) 2018; 97(36): 12192. doi:10.1097/MD.0000000000012192
  23. Howley M.M., Feldkamp M.L., Papadopoulos E.A., Fisher S.C., Arnold K.E., Browne M.L.; National Birth Defects Prevention Study.Maternal genitourinary infections and risk of birth defects in the National Birth Defect Prevention Study. Birth Defects Res. 2018; 110(19): 1443-54. doi: 10.1002/bdr2.1409.
  24. Keating G.M. Fosfomycin trometamol: a review of its use as a single-dose oral treatment for patients with acute lower urinary tract infections and pregnant women with asymptomatic bacteriuria. Drugs. 2013; 73(17): 1951-66. DOI: 10.1007/s40265-013-0143-y.
  25. Reeves D.S. Treatment of bacteriuria in pregnancy with single dose fosfomycin trometamol: A review. Infection. 1992; 20(Suppl 4): S313. https://doi.org/10.1007/BF01710022

Received 18.09.2019

Accepted 04.10.2019

About the Authors

Asiat Z. Khashukoeva, Doctor of Medical Sciences, Professor of the Department of Obstetrics and Gynecology of the Medical Faculty of the Russian National Research Medical University named N.I. Pyrogov. Phone: 8-916-340-38-13 E-mail: azk05@mail.ru
Address: 129226, Moscow, 1st Leonova str., 16 RGNKC.
Svetlana A. Khlynova, PhD, Associate Professor of the Department of Obstetrics and Gynecology of the Medical Faculty of the Russian National Research Medical University named N.I. PyrogovAddress: 105187, Moscow, 1 Fortunatovskaya str., building 10.
Phone: 8-926-280-63-67 E-mail: doc-khlinova@mail.ru
Svetlana B. Kerchelaeva, Doctor of Medical Sciences, Professor of the Department of Obstetrics and Gynecology of the Medical Faculty of the Russian National Research Medical University named N.I. Pyrogov.
Address: 105187, Moscow, 1 Fortunatovskaya str., building 2. Phone: 8-916-846-47-18 E-mail: ksb65@mail.ru

For citation: Khashukoeva A.Z., Khlynova S.A., Kerchelaeva S.B. Genitourinary infections in women: new opportunities for effective combined therapy.
Akusherstvo i Ginekologiya / Obstetrics and gynecology. 2019; 11: 221-25.(In Russian).
https://dx.doi.org/10.18565/aig.2019.11.221-225

Similar Articles

By continuing to use our site, you consent to the processing of cookies that ensure the proper functioning of the site.