About
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
ArchiveEthical StandardsSubscription
For authors
InstructionsInformed consent policyContract offerEASE GuidelinesICJME CriteriaWAME Recommendations on ChatGPT and Chatbots in Relation to Scholarly Publications
Reviewing
About
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
ArchiveEthical StandardsSubscription
For authors
InstructionsInformed consent policyContract offerEASE GuidelinesICJME CriteriaWAME Recommendations on ChatGPT and Chatbots in Relation to Scholarly Publications
Reviewing
Logout
Obstetrics and Gynegology2021№2
Clinical use of drugs containing...

Clinical use of drugs containing sertaconazole in the treatment of vulvovaginal candidiasis

DOI
https://dx.doi.org/10.18565/aig.2021.2.158-166

Apolikhina I.A., Gorbunova E.A., Malyshkina D.A., Donnikov A.E.

1) Academician V.I. Kulakov National Medical Research Centre for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia, Moscow, Russia; 2) I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia, Moscow, Russia
Vulvovaginal candidiasis (VVC) is one of the problems of modern health care which reduces the quality of life of women. Candida albicans is a representative of the normal microflora of the vagina. Under certain conditions it affects the mucous membrane and forms an aggressive biofilm. Recurrent VVC is detected in 20–50% of patients. The search for effective, easy-to-use, affordable medical preparations is a major clinical challenge for a doctor. This article provides an overview of such a condition as VVC, aspects of its diagnosis, treatment, and prevention, as well as a clinical example and a description of drugs containing sertaconazole.
Conclusion. Complex therapy provides a comprehensive approach to the treatment of VVC in three stages: primary hygiene (Zalagel Intim gel), treatment (vaginal Zalain suppository, Zalain cream), intimate hygiene (Zalagel Intim gel). The advantages of applying vaginal Zalain suppositories are their single use, the absence of a systemic effect and a wide spectrum of action (it acts on both Candida albicans and Candida non-albicans), the absence of cross-resistance of fungi to the drug, absence of effects on the normal vaginal microflora (lactobacilli), concomitant antibacterial activity (on the coccal flora) and anti-inflammatory effect. A single intravaginal administration of a suppository at a dose of 300 mg is a complete course of treatment in exacerbation of VVC.

Keywords

vulvovaginal candidiasis
sertaconazole
Candida albicans
Сandida non-albicans
antifungals
mycoses
Full text (in Russian)

References

  1. Zhu Y.X., Li T., Fan S.R., Liu X.P., Liang Y.H., Liu P. Health-related quality of life as measured with the Short-Form 36 (SF-36) questionnaire in patients with recurrent vulvovaginal candidiasis. Health Qual. Life Outcomes. 2016; 14: 65. https://dx.doi.org/10.1186/s12955-016-0470-2.
  2. Blostein F., Levin-Sparenberg E., Wagner J., Foxman B. Recurrent vulvovaginal candidiasis. Ann. Epidemiol. 2017; 27(9): 575-82. https://dx.doi.org/10.1016/j.annepidem.2017.08.010.
  3. Nyirjesy P., Peyton C., Weitz M.V., Mathew L., Culhane J.F. Causes of chronic vaginitis: analysis of a prospective database of affected women. Obstet. Gynecol. 2006; 108(5): 1185-91. https://dx.doi.org/10.1097/01.AOG.0000239103.67452.1a.
  4. Aballéa S., Guelfucci F., Wagner J., Khemiri A., Dietz J.P., Sobel J. et al. Subjective health status and health-related quality of life among women with recurrent vulvovaginal candidosis (RVVC) in Europe and the USA. Health Qual. Life Outcomes. 2013; 11: 169. https://dx.doi.org/10.1186/1477-7525-11-169.
  5. Foxman B., Muraglia R., Dietz J.P., Sobel J.D., Wagner J. Prevalence of recurrent vulvovaginal candidiasis in 5 European countries and the United States: results from an internet panel survey. J. Low. Genit. Tract Dis. 2013; 17(3): 340-5. https://dx.doi.org/10.1097/LGT.0b013e318273e8cf.
  6. Denning D.W., Kneale M., Sobel J.D., Rautemaa-Richardson R. Global burden of recurrent vulvovaginal candidiasis: a systematic review. Lancet Infect. Dis. 2018; 18(11): e339-47. https://dx.doi.org/10.1016/S1473-3099(18)30103-8.
  7. The International Society for the Study of Vulvovaginal Disease (ISSVD). Available at: https://www.issvd.org/
  8. Silva S., Rodrigues C.F., Araújo D., Rodrigues M.E., Henriques M. Candida species biofilms’ antifungal resistance. Fungi (Basel). 2017; 3(1): 8. https://dx.doi.org/10.3390/jof3010008.
  9. Netea M.G., Marodi L. Innate immune mechanisms for recognition and uptake of Candida species. Trends Immunol. 2010; 31(9): 346-53. https://dx.doi.org/ 10.1016/j.it.2010.06.007.
  10. Diezmann S., Cox C.J., Schonian G., Vilgalys R.J., Mitchell T.G. Phylogeny and evolution of medical species of Candida and related taxa: a multigenic analysis. J. Clin. Microbiol. 2004; 42(12): 5624-35. https://dx.doi.org/10.1128/JCM.42.12.5624-5635.2004.
  11. Anderson M.R., Klink K., Cohrssen A. Evaluation of vaginal complaints. JAMA. 2004; 291(11): 1368-79. https://dx.doi.org/10.1001/jama.291.11.1368.
  12. Berg A.O., Heidrich F.E., Fihn S.D., Bergman J.J., Wood R.W., Stamm W.E. et al. Establishing the cause of genitourinary symptoms in women in a family practice. Comparison of clinical examination and comprehensive microbiology. JAMA. 1984; 251(5): 620-5.
  13. Nobile C.J., Johnson A.D. Candida albicans biofilms and human disease. Annu. Rev. Microbiol. 2015; 69: 71-92. https://dx.doi.org/10.1146/annurev-micro-091014-104330.
  14. Poulain D. Candida albicans, plasticity and pathogenesis. Crit. Rev. Microbiol. 2015; 41(2): 208-17. https://dx.doi.org/10.3109/1040841X.2013.813904.
  15. Scorzoni L., de Paula e Silva A.C.A., Marcos C.M., Assato P.A., de Melo W.C.M.A., de Oliveira H.C. et al. Antifungal therapy: new advances in the understanding and treatment of mycosis. Front. Microbiol. 2017; 8: 36. https://dx.doi.org/10.3389/fmicb.2017.00036.
  16. Rodríguez-Cerdeira C., Martínez-Herrera E., Carnero-Gregorio M., López-Barcenas A., Fabbrocini G., Fida M. et al. Pathogenesis and clinical relevance of Candida biofilms in vulvovaginal candidiasis. Front. Microbiol. 2020; 11: 544480. https://dx.doi.org/10.3389/fmicb.2020.544480.
  17. Ramage G., Vande Walle K., Wickes B.L., Lopez-Ribot J.L. Standardized method for in vitro antifungal susceptibility testing of Candida albicans biofilms. Antimicrob. Agents Chemother. 2001; 45(9): 2475-9. https://dx.doi.org/10.1128/aac.45.9.2475-2479.2001.
  18. Uppuluri P., Chaturvedi A.K., Srinivasan A., Banerjee M., Ramasubramaniam A.K., Kohler J.R. et al. Dispersion as an important step in the Candida albicans biofilm developmental cycle. PLoS Pathog. 2010; 6(3): e1000828. https://dx.doi.org/10.1371/journal.ppat.1000828.
  19. Rosati D., Bruno M., Jaeger M., Ten Oever J., Netea M.G. Recurrent vulvovaginal candidiasis: an immunological perspective. Microorganisms. 2020; 8(2): 144. https://dx.doi.org/10.3390/microorganisms8020144.
  20. Российское общество акушеров-гинекологов. Клинические рекомендации по диагностике и лечению заболеваний, сопровождающихся патологическими выделениями из половых путей женщин. 2-е изд. М.; 2019. [Russian Society of Obstetricians and Gynecologists. Clinical recommendations for the diagnosis and treatment of diseases accompanied by pathological secretions from the genital tract of women. 2nd ed. Moscow. 2019. (in Russian)].
  21. Yano J., Sobel J.D., Nyirjesy P., Sobel R., Williams V.L., Yu Q. et al. Current patient perspectives of vulvovaginal candidiasis: incidence, symptoms, management and post-treatment outcomes. BMC Womens Health. 2019; 19: 48. https://dx.doi.org/10.1186/s12905-019-0748-8.
  22. van de Wijgert J.H., Borgdorff H., Verhelst R., Crucitti T., Francis S., Verstraelen H. et al. The vaginal microbiota: what have we learned after a decade of molecular characterization? PLoS One. 2014; 9(8): e105998. https://dx.doi.org/ 10.1371/journal.pone.0105998.
  23. Gunther L.S., Martins H.P., Gimenes F., Abreu A.L., Consolaro M.E., Svidzinski T.I. Prevalence of Candida albicans and non-albicans isolates from vaginal secretions: comparative evaluation of colonization, vaginal candidiasis and recurrent vaginal candidiasis in diabetic and non-diabetic women. Sao Paulo Med. J. 2014; 132(2): 116-20. https://dx.doi.org/10.1590/1516-3180.2014.1322640.
  24. Clinical alert to U.S. healthcare facilities: Global emergence of invasive infections caused by the multidrug-resistant yeast Candida auris. September 2017. Atlanta: Centers for Disease Control and Prevention, Clinical Update. Available at: https://www.cdc.gov/fungal/candida-auris/c-auris-alert-09-17.html Accessed 21 December 2018.
  25. European Centre for Disease Prevention and Control. Candida auris in healthcare settings – Europe. Stockholm: ECDC; 2018. 10p. Available at: https://ecdc.europa.eu/sites/portal/files/documents/RRA-Candida-auris-European-Union-countries-first-update.pdf
  26. Chowdhary A., Sharma C., Meis J.F. Candida auris: a rapidly emerging cause of hospital-acquired multidrug-resistant fungal infections globally. PLoS Pathog. 2017; 13(5): e1006290. https://dx.doi.org/10.1371/journal.ppat.1006290.
  27. Sobel J.D., Faro S., Force R.W., Foxman B., Ledger W.J., Nyirjesy P.R. et al. Vulvovaginal candidiasis: epidemiologic, diagnostic, and therapeutic considerations. Am. J. Obstet. Gynecol. 1998; 178(2): 203-11. https://dx.doi.org/10.1016/s0002-9378(98)80001-x.
  28. Egan M.E., Lipsky M.S. Diagnosis of vaginitis. Am. Fam. Physician. 2000; 62(5): 1095-104.
  29. Sherrard J., Donders G., White D., Jensen J.S. European IUSTI. European (IUSTI/WHO) guideline on the management of vaginal discharge, 2011. Int. J. STD AIDS. 2011; 22(8): 421-9. https://dx.doi.org/10.1258/ijsa.2011.011012.
  30. Mondello F., De Bernardis F., Girolamo A., Cassone A., Salvatore G. In vivo activity of terpinen-4-ol, the main bioactive component of Melaleuca alternifolia Cheel (tea tree) oil against azole-susceptible and -resistant human pathogenic Candida species. BMC Infect. Dis. 2006; 6: 158. https://dx.doi.org/10.1186/1471-2334-6-158.
  31. Hammer K.A., Carson C.F., Riley T.V. In vitro susceptibilities of lactobacilli and organisms associated with bacterial vaginosis to Melaleuca alternifolia (tea tree) oil. Antimicrob. Agents Chemother. 1999; 43(1): 196. https://dx.doi.org/10.1128/AAC.43.1.196.
  32. Pena E.F. Melaleuca alternifolia oil. Its use for trichomonal vaginitis and other vaginal infections. Obstet. Gynecol. 1962; 19: 793-5.
  33. Astani A., Reichling J., Schnitzler P. Comparative study on the antiviral activity of selected monoterpenes derived from essential oils. Phytother. Res. 2009; 24(5): 673-9. https://dx.doi.org/10.1002/ptr.2955.
  34. Carson C.F., Hammer K.A., Riley T.V. Melaleuca alternifolia (tea tree) oil: a review of antimicrobial and other medicinal properties. Clin. Microbiol. Rev. 2006; 19(1): 50-62. https://dx.doi.org/10.1128/CMR.19.1.50-62.2006.
  35. Bassett I.B., Pannowitz D.L., Barnetson R.S. A comparative study of tea-tree oil versus benzoylperoxide in the treatment of acne. Med. J. Aust. 1990; 153(8): 455-8. https://dx.doi.org/10.5694/j.1326-5377.1990.tb126150.x.
  36. Байрамова Г.Р., Баранов И.И., Припутневич Т.В., Чернова В.Ф. Вульвовагинальный кандидоз: клинические и терапевтические аспекты в практике акушера-гинеколога. Акушерство и гинекология: новости, мнения, обучение. 2017; 4: 63-9. [Bayramova G.R., Baranov I.I., Priputnevich T.V., Chernova V.F. Vulvovaginal candidiasis: clinical and therapeutic aspects in the practice of an obstetrician-gynecologist. Obstetrics and gynecology: News. Opinions. Training. 2017; 4: 63-9. (in Russian)].
  37. Прилепская В.Н., Байрамова Г.Р. Вульвовагинальный кандидоз современные пути решения проблемы. Трудный пациент. 2006; 4(9): 33-6. [Prilepskaya V. N., Bayramova G. R. Vulvovaginal candidiasis modern ways of solving the problem. A difficult patient. 2006; 4(9): 33-6. (in Russian)].
  38. Бекаева Н.Н., Ковальчук В.И. Опыт применения препарата Залаин при лечении рецидивирующего вульвовагинального кандидоза. Вестник хирургии Казахстана. 2012; 4: 72-4. [Bekaeva N. N., Kovalchuk V.I. Experience of using the drug Zalain in the treatment of recurrent vulvovaginal candidiasis. Bulletin of Surgery of Kazakhstan. 2012; 4: 72-4. (in Russian)].
  39. Palacin C., Tarrago C., Ortiz J.A. Sertaconazole: pharmacology of a gynecological antifungal agent. Int. J. Gynaecol. Obstet. 2000; 71(Suppl. 1): S37-46. https://dx.doi.org/10.1016/s0020-7292(00)00351-9.
  40. Yu X.Y., Fu F., Kong W.N., Xuan Q.K., Wen D.H., Chen X.Q. et al. Streptococcus agalactiae inhibits Candida albicans hyphal development and diminishes host vaginal mucosal TH17 response. Front. Microbiol. 2018; 9: 198. https://dx.doi.org/10.3389/fmicb.2018.00198.
  41. Galask R.P. Vaginal colonization by bacteria and yeast. Am. J. Obstet. Gynecol. 1988; 158(4): 993-5. https://dx.doi.org/10.1016/0002-9378(88)90111-1.
  42. Логутова Л.С., Гаспарян Н.Д., Горенкова О.С., Кручинина Е.В., Алимова Н.Г. Противорецидивный эффект различных антимикотических препаратов местного действия. Акушерство и гинекология. 2008; 3: 53-6. [Logutova L.S., Gasparyan N.D. Anti-relapse effect of various local antimycotic drugs. Obstetrics and gynecology. 2008; 3: 53-6. (in Russian)].
  43. Carrillo-Munoz A.J., Fernández-Torres B., Cárdenes D.C., Guarro J. In vitro activity of sertaconazole against dermatophyte isolates with reduced fluconazole susceptibility. Chemotherapy. 2003; 49(5): 248-51. https://dx.doi.org/10.1159/000072449.
  44. Agut J., Tarrida N., Sacristán A., Ortiz J.A. Antiinflammatory activity of topically applied sertaconazole nitrate. Methods Find. Exp. Clin. Pharmacol. 1996; 18(4): 233-4.
  45. Arastehfar A., Gabaldón T., Garcia-Rubio R., Jenks J.D., Hoenigl M., Salzer H.J.F. et al. Drug-resistant fungi: an emerging challenge threatening our limited antifungal armamentarium. Antibiotics (Basel). 2020; 9(12): 877. https://dx.doi.org/10.3390/antibiotics9120877.

Received 04.02.2021

Accepted 08.02.2021

About the Authors

Inna A. Apolikhina, MD, Head of the Department of Aesthetic Gynecology and Rehabilitation, Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia; Professor of the Department of Obstetrics, Gynecology, Perinatology and Reproductology, Institute of Professional Education, I.M. Sechenov First MSMU, Ministry of Health of Russia (Sechenov University). E-mail: i_apolikhina@oparina4.ru.
117997, Russia, Moscow, Oparina str., 4.
Elena A. Gorbunova, obstetrician-gynecologist, physiotherapist of the Department of Aesthetic Gynecology and Rehabilitation, Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia. E-mail: lifehelen@gmail.com.
117997, Russia, Moscow, Oparina str., 4.
Darya A. Malyshkina, graduate student, Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology,
Ministry of Health of Russia. E-mail: nidsumi@mail.ru. 117997, Russia, Moscow, Oparina str., 4.
Andrey E. Donnikov, PhD, Head of the Laboratory of Molecular Genetic Methods, Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia. E-mail: donnikov@dna-technology.ru. 117997, Russia, Moscow, Oparina str., 4.

For citation: Apolikhina I.A., Gorbunova E.A., Malyshkina D.A., Donnikov A.E. Clinical use of drugs containing sertaconazole in the treatment of vulvovaginal candidiasis.
Akusherstvo i Ginekologiya / Obstetrics and gynecology. 2021; 2: 158-166 (in Russian)
https://dx.doi.org/10.18565/aig.2021.2.158-166

Similar Articles

№12 / 2018
Manukhin I.B., Abashova E.I., Bazina M.I., Gerasimov A.M., Katkova N.Yu., Maltseva L.I., Olina A.A., Tkachenko L.V.
Lactobacteria LCR35 for prevention of relapse of vulvovaginal candidiasis: results of the multicenter open non-interventional study
№12 / 2018
Kovalyk V.P., Matushevskaya E.V., Vladimirova E.V.
Vaginal discharge unassociated with sexually transmitted infections in reproductive-aged women
№11 / 2023
Tyutyunnik V.L., Kan N.E., Tezikov Yu.V., Lipatov I.S., Mikhailova O.I., Mirzabekova D.D.
Complex therapy of recurrent vulvovaginal candidiasis in pregnancy
№8 / 2024
Shadrova P.A., Bondarenko K.R., Guschin A.E., Zatevalov A.M., Metalnikova V.O., Dobrokhotova Yu.E.
Effect of vaginal microbiota composition in early pregnancy on pregnancy course and outcomes
№10 / 2024
Dobrokhotova Yu.E., Borovkova E.I., Burdenko M.V., Kovler S.E.
Long-term outcomes of prolonged fenticonazole therapy in patients with recurrent vulvovaginal candidiasis
By continuing to use our site, you consent to the processing of cookies that ensure the proper functioning of the site.