Probiotics for prophylaxis of vulvovaginal candidiasis relapses: Results of the international multicenter open-label REVOLACT study

Bashmakova N.V., Volkova N.Yu., Gnatko E.P., Dankova I.V., Dobrokhotova Yu.E., Karahalis L.Yu., Maltseva L.I., Nadelyaeva Ya.G., Potapov V.A., Serova O.F., Suturina L.V., Tarasova M.A., Tatarchuk T.F.

1Ural Research Institute of Maternal and Infant Care, Yekaterinburg, Repina str. 1, Russia 2Consultative and Diagnostic Center of Pechersky district, Kiev 01042 L. Ukrainka Boulevard, 36-V, Ukraine 3City Maternity Hospital № 6, Kiev 02125, P. Zaporozhets str. 26-A, Ukraine 4N.I. Pirogov Russian National Research Medical University, Moscow 117997, Ostrovityanova str. 1, Russia 5Regional Clinical Hospital № 2, Krasnodar 350012, Krasniy Partizan str. 6/2, Russia 6Obstetrics and Gynecology Department One, Kazan State Medical Academy, Kazan 420012, Mushtari str. 11, Russia 7Scientific Center for Family Health and Human Reproduction, Irkutsk 644003, Timiryazeva str. 16, Russia 8City Maternity Hospital № 1, Dnepropetrovsk 49000, Lenina str. 2, Ukraine 9D.O. Ott Scientific Research Institute of Obstetrics and Gynecology, St. Petersburg 199034, Mendeleevskaya line, 3, Russia 10Moscow Regional Perinatal Center, Balashikha 143900, sh. Enthusiasts, 12, Russia 11City Clinical Endocrinology Center, Kyiv 01034, Reitarskaya str. 22, Ukraine
Objective. To evaluate efficacy and safety of L. casei rhamnosus Doderleini strain (lactogynal, vaginal capsules), for prevention of recurrences of vulvovaginal candidiasis in the multicenter international multicenter open-label REVOLACT study. Subject and methods. After antimycotic therapy using sertaconazole (zalain, suppository 300 mg once and 2% cream 2 times a day for 8 days), female patients from main group (74 women) received intravaginal lactobacillus lactogynal within 21 days; the comparison group (80 women) of patients did not receive any probiotics. The period of dynamic observation of patients was 5 months, during which the registration of recurrences of vulvovaginal candidiasis (reporter and laboratory confirmed) was conducted. Results. Results demonstrate the effectiveness of combined therapy using sertaconazole (zalain, suppository 300 mg once and 2% cream 2 times a day for 8 days) followed by the application lactogynal within 21 days to prevent recurrence of vulvovaginal candidiasis compared to monotherapy with sertaconazole (zalain, suppository 300 mg once and 2% cream 2 times a day for 8 days). Time before relapse of vulvovaginal candidiasis after therapy with sertaconazole in the lactogynal group was 148.45±2.04 days and 137.40±4.41 days in the comparison group. The incidence of vulvovaginal candidiasis in the lactogynal group was significantly lower: 12 patients (16.2%) vs. 24 patients (30%) in the comparison group (p <0.05). Conclusion. Study demonstrates the efficacy and safety of L. casei rhamnosus Doderleini culture (lactogynal, vaginal capsules) in the complex treatment of vulvovaginal candidiasis for the prevention of relapse.

Keywords

probiotic
relapse
vulvovaginal candidiasis
lactoginal
LCR35

Supplementary Materials

  1. Table 1. General characteristics of the examined women
  2. Table 2. Exacerbations of vulvovaginal candidiasis in all study visits
  3. Table 3. Absolute and relative risk of recurrent vulvovaginal candidiasis

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Received 21.04.2017

Accepted 28.04.2017

About the Authors

Bashmakova Nadezhda, MD, professor, director of the Ural Research Institute for Maternity and Infancy. Russia, Yekaterinburg, Repina str. 1
Volkova Natalia, head of the gynecological department of the Consultative and Diagnostic Center of Pechersky district, Kiev. 01042 Ukraine, Kiev, L. Ukrainka Boulevard, 36-V
Gnatko Elena, MD, Professor, City Maternity Hospital № 6. 02125, Ukraine, Kyiv, P. Zaporozhets str. 26-A
Dankova Irina, candidate of medical science, senior researcher, Research Department of Preservation of Reproductive Function,
Ural Research Institute for Maternity and Infancy. Address: Russia, Yekaterinburg, Repina str. 1
Dobrokhotova Yulia, MD, Professor, head of the Department of Obstetrics and Gynecology, N.I. Pirogov Russian National Research Medical University.
117997, Russia, Moscow, Ostrovityanova str. 1
Karakhalis Lyudmila Yurievna, MD, professor, Regional Clinical Hospital No. 2. 350012, Russia, Krasnodar, Krasniy Partizan str. 6/2
Maltseva Larisa, Head of the Obstetrics and Gynecology Department One, Kazan State Medical Academy. 420012, Russia, Kazan, Mushtari str. 11
Nadeliaeva Yana, Ph.D., researcher of the laboratory of gynecological endocrinology, Scientific Center for Family Health and Human Reproduction.
644003, Russia, Irkustk, Timiryazeva str. 16
Potapov Valentin, MD, Professor, City Maternity Hospital № 1. 49000, Ukraine, Dnepropetrovsk, Lenina str. 2
Serova Olga Fedorovna, chief physician of the Moscow Regional Perinatal Center. 143900, Russia, Moscow Region, Balashikha, sh. Enthusiasts, 12
Suturina Larissa Viktorovna, MD, professor, head of the reproductive department of the Scientific Center for Family Health and Human Reproduction.
644003, Russia, Irkutsk, Timiryazeva str. 16
Tarasova Marina Anatolievna, MD, Professor, D.O. Ott Scientific Research Institute of Obstetrics and Gynecology.
199034, Russia, St. Petersburg, Mendeleevskaya line, 3. E-mail: tarasova@ott.ru
Tatarchuk Tatyana Feofanovna, MD, Professor, City Clinical Endocrinology Center. 01034, Ukraine, Kyiv, Reitarskaya str. 22

For citations: Bashmakova N.V., Volkova N.Yu., Gnatko E.P., Dankova I.V., Dobrokhotova Yu.E., Karahalis L.Yu., Maltseva L.I., Nadelyaeva Ya.G., Potapov V.A., Serova O.F., Suturina L.V., Tarasova M.A., Tatarchuk T.F. Probiotics for prophylaxis of vulvovaginal candidiasis relapses: Results of the international multicenter open-label REVOLACT study.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2017; (6): 136-42. (in Russian)
http://dx.doi.org/10.18565/aig.2017.6.136-42

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