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The Journal "Obstetrics and Gynecology"Journal HistoryAims and ScopePolicies on Conflict of Interest, Human and Animal Rights, and Informed ConsentEditorial ProcessData sharing statementAdvertising PolicyThe Process for Handling Cases Requiring Corrections, Retractions, and Editorial Expressions of ConcernEditorial BoardEditorial CounsilInformation for ProfessionalsNewsContacts
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Obstetrics and Gynegology2020№6
New possibilities of therapy bacterial...

New possibilities of therapy bacterial vaginosis: experience an antibiotic used concurrently with a prebiotic in bacterial vaginosis

DOI
https://dx.doi.org/10.18565/aig.2020.6.105-114

Manukhin I.B., Balan V.E., Dobrokhotova Yu.E., Krutova V.A., Kutueva F.R., Sakhautdinova I.V., Tapilskaya N.I., Fedulova N.M., Chernyshova L.V.

1) A.I. Evdokimov Moscow State University of Medicine and Dentistry, Moscow, Russia; 2) N.I. Pirogov Russian National Research Medical University, Moscow, Russia; 3) Kuban State Medical University, Krasnodar, Russia; 4) Women's Health Clinic Twenty-Two, Saint Petersburg, Russia; 5) Moscow Regional Research Institute of Obstetrics and Gynecology, Moscow, Russia; 6) Bashkir State Medical University, Ufa, Russia; 7) D.O. Ott Research Institute of Obstetrics, Gynecology, and Reproductology, Saint Petersburg, Russia; 8) OOO “Aurora Medi”, Saint Petersburg, Russia; 9) ZAO “Nasledniki” (Heirs), Moscow, Russia
Objective. To evaluate the efficiency and safety of therapy for bacterial vaginosis (BV) with Lactogynal vaginal capsules and clindamycin vaginal cream 2%.
Subjects and methods. Group 1 received clindamycin and Lactogynal for 7 days, then only Lactogynal for 7 days; Group 2 used clindamycin and Lactogynal for 7 days; Group 3 had clindamycin for 7 days, then Lactogynal for 7 days. After therapy, the patients were followed up for 15–24 days.
Results. At 2 weeks after therapy, the clinical cure rates were 88.9% in Group 1, 86.4% in Group 2, and 87.0% in Group 3. The laboratory cure rates according to the Amsel criteria were 95.6, 93.2, and 93.5% in Groups 1, 2, and 3, respectively; those according to the Nugent criteria were 95.6, 90.9, and 93.5% in Groups 1, 2, 3. The PCR cure rates were 77.8, 61.4, and 69.6% in Groups 1, 2, and 3, respectively. The global assessment of clinical and laboratory efficiencies revealed that the total therapeutic cure rates were 66.7% in Group 1, 59.1% in Group 2, and 63.0% in Group 3. The therapy was proven to be no less effective in the study group (Group 1) than in the control group (Group 3).
Conclusion. The trial showed that the regimen involving Lactogynal used concurrently with the antibiotic and that of sequential use of the former were comparably effective. The concurrent use of Lactogynal with antibacterial therapy to restore the normal vaginal microflora in the therapy of bacterial vaginosis can increase adherence to treatment, and, therefore, achieve its general effect.

Keywords

bacterial vaginosis
Lactogynal
vaginal discharge
Full text (in Russian)

References

  1. Шейка матки, влагалище, вульва. Физиология, патология, кольпоскопия, эстетическая коррекция: руководство для практикующих врачей. Под ред. С.И. Роговской, Е.В. Липовой. М.: Издательство журнала StatusPraesens, 2014. 250 с. [The cervix, vagina, vulva. Physiology, pathology, colposcopy, aesthetic correction: a guide for practitioners. edited by S.I. Rogovskaya, E.V. Lipova. Moscow: publishing house of the journal StatusPraesens, 2014. 250 р. (in Russian)].
  2. Федеральные клинические рекомендации РОАГ «Диагностика и лечение заболеваний, сопровождающихся патологическими выделениями из половых путей женщин», 2019. [Federal clinical recommendations of the ROAG “Diagnosis and treatment of diseases accompanied by pathological secretions from the genital tract of women”, 2019. (in Russian)].
  3. Larsson P.G., Platz­Christensen J.J., Thejls H. et al. Incidence of pelvic infammatory disease after first­trimester legal abortion in women with bacterialvaginosis after treatment with etronidazole: a double­blind, randomized study. Am. J. Obstet. Gynecol. 1992; 166 (1 Pt. 1): 100-103.
  4. Persson E., Bergstrom M., Larsson P.G. et al. Infections after hysterectomy. A prospective ation­wide Swedish study. The study group on infectious diseases in obstetrics and gynecology within the Swedish Society of obstetrics and gynecology. Acta Obstet. Gynecol. Scand. 1996; 75: 757-761.
  5. Charonis G., Larsson P.G. Use of pH/whiff test or QuickVue Advanced pH and Amines test for the diagnosis of bacterial vaginosis and prevention of postabortion pelvic infammatory disease. Acta Obstet. Gynecol. Scand. 2006; 85: 837-843.
  6. Национальное руководство по гинекологии. Под ред. В.И. Кулакова и др. М.: ГЭОТАР­Медиа, 2009. 1088 с. [National manual of obstetrics. Edited byV. I. Kulakov and others. M.: GEOTAR-Media, 2009. 1088 p. (in Russian)].
  7. Birnbaumer D.M., Anderegg C. Sexually transmitted diseases. J.A. Marx et al. (Eds.). Rosen’s Emergency Medicine: Concepts and Clinical Practice. 7th ed. Philadelphia. Pa: Mosby Elsevier, 2009.
  8. Atashili J., Poole C., Ndumbe P.M. et al. Bacterial vaginosis and HIV acquisition: a meta­analysis of published studies. AIDS. 2008; 22: 1493-1501.
  9. Chohan V.H., Baeten J., Benki S. et al. A prospective study of risk factors for herpes simplex virus Type 2 Acquisition among high­risk HIV­1 Sero­ negative Kenyan Women. Sex Transm. Infect. 2009; 85: 489-492.
  10. van de Wijgert J.H., Morrison C.S., Cornelisse P.G. et al. Bacterial vaginosis and vaginal yeast, but not vaginal cleansing, increase HIV­1 acquisition in African women. J. Acquir. Immune. Defc. Syndr. 2008; 48: 203-210.
  11. UN General Assembly Resolution A/RES/71/3, 5 October 2016, A/RES/71/3 (2016). Political declaration of the high-level meeting of the General Assembly on antimicrobial resistance.
  12. Mishra R.K., Segal E., Lipovsky A., Natan M., Banin E., Gedanken A. New life for an old antibiotic. ACS Appl. Mater. Interfaces. 2015; 7(13): 7324-33.
  13. David A. Eschenbach. Bacterial Vaginosis: Resistance, Recurrence, and/or Reinfection? Clinical Infectious Diseases. 2007; 44 (2): 220-221.
  14. Beigi R.H., Austin M.N., Meyn L.A. et al. Antimicrobial resistance associated with the treatment of bacterial vaginosis. Am J Obstet Gynecol. 2004; 191: 1124.
  15. Macklaim J.M., Clemente J.C., Knight R., Gloor G.B., Reid G. Changes in vaginal microbiota following antimicrobial and probiotic therapy. Microb. Ecol. Health Dis. 2015; 26: 277-99.
  16. Сгибнев А.В., Кремлева Е.А. Метаболиты нормальной микрофлоры влагалища повышают активность антибиотиков. Акушерство и гинекология. 2017; (3): 108-14. [Sgibnev A.V., Kremleva E.A. Metabolites of the normal vaginal microflora increase the activity of antibiotics. Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2017; (3): 108-14. (in Russian)].
  17. Sgibnev A., Kremleva E. Influence of hydrogen peroxide, lactic acid, and surfactants from vaginal lactobacilli on the antibiotic sensitivity of opportunistic bacteria. Probiotics and antimicrobial proteins. 2017; 9(2): 131-41.
  18. Савичева А.М., Рыбина Е.В. Исследование in vitro роста, размножения, антибиотикорезистентности, конкурентных взаимоотношений штамма Lactobacillus casei rhamnosus. Акушерство и гинекология. 2014; 7: 79-83. [Savicheva A.M., Rybina E.V. In vitro study of growth, reproduction, antibiotic resistance, and competitive relationships of the Lactobacillus casei rhamnosus strain. Obstetrics and gynecology. 2014; 7: 79-83 (in Russian)].
  19. Подзолкова Н.В., Созаева Л.Г., Иванычева И.Д., Пономарева И.В. Возможности одноэтапной терапии больных с бактериальным вагинозом (результаты многоцентрового открытого проспективного пилотного исследования). Российский вестник акушера-гинеколога. 2015; 3: 70-75. [Podzolkova N.V., Sosayeva L.G., Ivanycheva I.D., Ponomareva I.V. Possibilities of one-stage therapy of patients with bacterial vaginosis (results of a multicenter open prospective pilot study). Russian Bulletin of obstetrician-gynecologist. 2015; 3: 70-75. (in Russian)].
  20. Ляшенко А.А., Свищева М.С. Методология расчета объема выборки в сравнительных контролируемых клинических исследованиях с «неменьшей эффективностью»: сравнение двух пропорций в параллельных группах. Качественная клиническая практика. 2014; 3: 24-28. [Lyashenko A.A., Svishcheva M.S. Methodology for calculating the sample size in comparative controlled clinical trials with “no less effectiveness”: comparison of two proportions in parallel groups. Qualitative clinical practice. 2014; 3: 24-28. (in Russian)].
  21. Committee for proprietary medicinal products (CPMP) (2004). Points to consider on the choice of non-inferiority margin.
  22. Dunnett C.W., Gent M. Signifcance testing to establish equivalence between treatments, with special reference to data in the form of 2X2 tables. Biometrics. 197; 33(4): 593-602.
  23. Borgdorff H., Armstrong S.D., Tytgat H.L. et al. Unique insights in the cervicovaginal Lactobacillus iners and L. crispatus Proteomes and their associations with microbiota dysbiosis. PLoS ONE. 2016; 11: e0150767. DOI: 10.1371/journal.pone.0150767.
  24. Petricevic L., Witt A. The role of Lactobacillus casei rhamnosus Lcr35 in restoring the normal vaginal flora after antibiotic treatment of bacterial vaginosis. BJOG. 2008; 115: 1369-1374.

Received 09.06.2020

Accepted 18.06.2020

About the Authors

Igor B. Manukhin, MD, Professor, Head of the Department of obstetrics and gynecology, Therapeutical Faculty A.I. Evdokimov MGMSU. Tel.: +7(499)178-28-31.
E-mail: katemanu@mail.ru. 20/1 Delegatskaya str., Moscow, 127473, Russia.
Vera E. Balan, MD, Professor, Head of the Polyclinic Department, Moscow regional Research Institute of Obstetrics and Gynecology. Tel.: +7(495)624-50-66.
E-mail: balanmed@gmail.com. 22A Pokrovka str., Moscow, 101000, Russia.
Yulia E. Dobrokhotova, N.I. Pirogov RNRMU HPE SEI, Therapeutical Faculty, Obstetrics and Gynecology Department. Tel: +7(495)722-63-99. E-mail: pr.dobrohotova@mail.ru.
1/9 Ostrovitianov str., Moscow, 117997, Russia.
Viktoriya A. Krutova, MD, Professor of the Department of obstetrics, gynecology and Perinatology, Kuban State Medical University of the Ministry of Health of the Russian Federation. Tel: +7(861)275-60-70. Email: vik_krutova@yandex.ru. 4 Sedina str., Krasnodar, 350072, Russia.
Flora R. Kutueva, PhD, Honored Doctor of the Russian Federation, assistant of the Department of obstetrics and gynecology, Saint Petersburg State Pediatric Medical University Ministry of Health of the Russian Federation. Tel: +7(812)296-31-08. E-mail: flora-kutueva@mail.ru. 2 Litovskaya str., Saint Petersburg, 194100, Russia.
Indira V. Sakhautdinova, MD, Professor, Head of the Department of obstetrics and gynecology No. 1 FGBOU HE “Bashkir State Medical University” of the Ministry of Health of the Russian Federation. Tel: +7(347)272-41-73. E-mail: indira2127@yandex.ru. 23 Tukaeva str., Ufa, 450002, Republic of Bashkortostan.
Natalia I. Tapilskaya, MD, Professor of the Department of obstetrics and gynecology with the course of gynecology for children, Saint Petersburg State Pediatric Medical University Ministry of Health of the Russian Federation. Tel: +7(812)328-98-22. E-mail: tapnatalia@yandex.ru. 2 Litovskaya str., Saint Petersburg, 194100, Rusia.
Natalia M. Fedulova, obstetrician-gynecologist at Aurora Medi LLC., Tel: +7(812)333-00-22. E-mail: fedulovaru1@rambler.ru.
5-3 Kievskaya str., Saint Petersburg, 196084, Russia.
Lyudmila V. Chernyshova, obstetrician-gynecologist, Deputy chief physician of JSC “Inheritors”. Tel: +7(495)730-17-00. E-mail: 7251336@mail.ru.
7 Michurinsky prospekt, Moscow, 119192, Russia.

For reference: Manukhin I.B., Balan V.E., Dobrokhotova Yu.E., Krutova V.A., Kutueva F.R., Sakhautdinova I.V., Tapilskaya N.I., Fedulova N.M., Chernyshova L.V. New possibilities of therapy bacterial vaginosis: experience an antibiotic used concurrently with a prebiotic in bacterial vaginosis.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2020; 6: 105-114 (in Russian).
https://dx.doi.org/10.18565/aig.2020.6.105-114

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