Results of a multicenter observational study: therapy for acute non-specific and mixed vaginitis in reproductive-aged patients
Objective. To evaluate the clinical and laboratory efficiency of two-step therapy with Depantol and Femilex for acute nonspecific and mixed vaginitis. Subjects and methods. The prospective observational study enrolled 200 patients aged 18-45 years with acute nonspecific and mixed (bacterial-fungal) vaginitis, who were stratified according to the diagnosis and the presence of pregnancy. All the patients underwent pH measurements over time and microscopic and molecular biological studies of vaginal discharge using the femoflor test, by evaluating microbiocenosis. Vaginitis therapy included Depantol as 1 vaginal suppository twice daily for 7 days, then Femilex as 1 vaginal suppository daily for 10 days. Descriptive statistical methods; one-way analysis of variance; a test for difference in proportions and means; Student’s t-test; a chi-square (χ2) test; and a paired Wilcoxon test were used in the analysis. The differences were considered significant at p <0.05. Results. Depantol and Femilex used for two-step therapy for acute nonspecific and mixed vaginitis achieved a clinical and laboratory efficiency of 91% and there were no significant differences between non-pregnant and pregnant women. The recurrence rate for vaginitis after two-month follow-up is determined by accompanying risk factors and does not exceed 3%. Conclusion. The sequential use of Depantol vaginal suppositories for 7 days and Femilex vaginal suppositories for 10 days is an effective two-step treatment regimen for acute nonspecific and mixed (bacterial-fungal) vaginitis in reproductive-aged women, which allows restoration of normocenosis in more than 90% of patients.Radzinsky V.E., Khamoshina M.B., Orazov M.R., Tulupova M.S., Pestrikova T.Yu., Yarmolinskaya M.I., Rymashevsky A.N.
Keywords
acute vaginitis
Depantol
Femilex
vaginitis therapy
vaginitis in pregnant women
References
- Радзинский В.Е., Хамошина М.Б. Нерешенные проблемы современной гинекологии: Quo vadis? Доктор.Ру. 2016; 7 (124): 4-9. [Radzinsky V.E., Khamoshina M.B. Unresolved problems of modern gynecology: Quo vadis? Doctor.Ru. 2016; 7 (124): 4-9. (in Russ.)].
- Radzinskiy V.E., Khamoshina M.B., Arkhipova M.P., Lichak N.V. Reproductive health of adolescents in Russia: statistics, problems and prospects of improvement. Gynecological Endocrinology. 2014; 30 (1): 2-5.
- Тулупова М.С., Хамошина М.Б. Репродуктивное здоровье мужчин в парах, страдающих невынашиванием беременности. Вестник РУДН. 2011; 5: 274-279. [Tulupova M.S, Khamoshina M.B. Reproductive health of men in couples suffering from miscarriage. Bulletin of the RUDN University. 2011; 5: 274-279. (in Russ.)].
- Palmeira-de-Oliveira R., Palmeira-de-Oliveira A., Martinezde-Oliveira J. New strategies for local treatment of vaginal infections. Adv Drug Deliv Rev 2015; 92: 105-122.
- Villaseca R., Ovalle A., Amaya F. et al. Vaginal infections in a family health clinic in the metropolitan region, Chile. Rev Chilena Infectol 2015; 32: 30-36 (In Spanish).
- Fan A.P., Xue F.X. Clinical characteristics of aerobic vaginitis and its mixed infections. Zhonghua Fu Chan Ke Za Zhi. 2010; 45: 904-908 (In Chinese).
- Клинические рекомендации по диагностике и лечению заболеваний, сопровождающихся патологическими выделениями из половых путей женщин (издание 2-е, исправленное и дополненное). Российское общество акушеров-гинекологов. 2019. 56 с. [Clinical recommendations for the diagnosis and treatment of diseases accompanied by pathological discharge from the genital tract of women (2nd edition, corrected and supplemented). Russian Society of Obstetricians and Gynecologists. 2019. 56 р. (in Russ.)].
- Анкирская А.С. Неспецифический вагинит. Гинекология. 2005; 4: 15-8. [Ankirskaya A.S. Nonspecific vaginitis. Gynecology. 2005; 4: 15-8. (in Russ.)].
- Dermendjiev T., Pehlivanov B., Hadjieva K., Stanev S. Epidemiological, clinical and microbiological findings in women with aerobic vaginitis. Akush Ginekol (Sofiia). 2015; 54(9): 4-8.
- Liang Q., Li N., Song S., Zhang A., Li N., Duan Y. High-dose nifuratel for simple and mixed aerobic vaginitis: A single-center prospective open-label cohort study. Journal of Obstetrics and Gynaecology Research. 2016; 42(10): 1354-60.
- Costerton J.W., Stewart P.S., Greenberg E.P. Bacterial biofilms: a common cause of persistent infections. Science. 1999; 284(5418): 1318-22.
- Hardy L., Cerca N., Jespers V., Vaneechoutte M., Crucitti T. Bacterial biofilms in the vagina. Res Microbiol. 2017; 168 (9-10): 865-74.
- Радзинский В.Е., Хамошина М.Б., Шеленина Л.А., Климова О.И., Лебедева М.Г., Замотина И.В. Терапия вагинальных инфекций: грани проблемы (международные реалии и российский опыт). Доктор. Ру. Гинекология. Эндокринология. 2013; 7 (85): 13-7. [Radzinsky V.E., Khamoshina M.B., Shelenina L.A., Klimova O.I., Lebedeva M.G., Zamotina I.V. Therapy of vaginal infections: facets of the problem (international realities and Russian experience). Doctor. RU. Gynecology. Endocrinology. 2013; 7 (85): 13-7. (in Russ.)].
- Радзинский В.Е. Акушерская агрессия. М.: Медиабюро Status Presens; 2017. 872 с. [Radzinsky V.E. Obstetric aggression. M.: Media Bureau Status Presens; 2017. 872 р. (in Russ.)].
- Хамошина М.Б., Радзинский В.Е., Календжян А.С., Рубцова А.Ю. Нарушения микробиоценоза урогенитального тракта: грани проблемы, перспективы коррекции и профилактики. Вопросы гинекологии, акушерства и перинатологии. 2009; 8 (5); 69-74. [Khamoshina M.B., Radzinsky V.E., Kalendzhyan A.S., Rubtsova A.Yu. Violations of the microbiocenosis of the urogenital tract: facets of the problem, prospects for correction and prevention. Questions of gynecology, obstetrics and perinatology. 2009; 8 (5); 69-74. (in Russ.)].
- Collignon P. Antibiotic resistance: are we all doomed? Intern Med J. 2015; 45 (11): 1109-15.
- Torumkuney D., Mayanskiy N., Edelstein M., Sidorenko S., Kozhevin R., Morrissey I. Results from the Survey of Antibiotic Resistance (SOAR) 2014-16 in Russia. J. Antimicrob. Chemother. 2018; 73 (5): v14-v21.
- Распоряжение Правительства РФ от 25 сентября 2017 г. № 2045-р «О Стратегии предупреждения распространения антимикробной резистентности в РФ на период до 2030 г.» [Decree of the Government of the Russian Federation of September 25, 2017 No. 2045-r «On the Strategy for Preventing the Spread of Antimicrobial Resistance in the Russian Federation for the Period Until 2030». (in Russian)]. https://www.garant.ru/products/ipo/prime/ doc/71677266/
- Чотчаева А.И., Тулупова М.С., Хамошина М.Б., Чакчурина И.А. Факторы, влияющие на течение гестационного периода у женщин с угрозой прерывания беременности во втором триместре. Доктор. Ру. Гинекология. Эндокринология. 2010; 1 (69): 48-51. [Chotchaeva A.I., Tulupova M.S., Khamoshina M.B., Chakchurina I.A. Factors affecting the course of the gestational period in women with the threat of termination of pregnancy in the second trimester. Doctor. RU. Gynecology. Endocrinology. 2010; 1 (69): 48-51. (in Russ.)].
- Donders G., Bellen G., Rezeberga D. Aerobic vaginitis in pregnancy. BJOG. 2011; 118 (10): 1163-70.
- Депантол. Инструкция по медицинскому применению препарата, зарегистрированная Минздравом РФ (по grls.rosminzdrav.ru). Регистрационный номер ЛСР-003902/07. [Depantol. Instructions for the medical use of the drug, registered by the Ministry of Health of the Russian Federation (by grls.rosminzdrav.ru). Registration number LSR-003902/07. (in Russ.)].
- Ohlsson A.I., Shah V.S., Stade B.C. Vaginal chlorhexidine during labour to prevent early-onset neonatal group B streptococcal infection.Cochrane Database Syst Rev. 2014 Dec 14;(12):CD003520.
- Радзинский В.Е., Петрова В.Д., Хамошина М.Б., Салимова Л.Я., Руднева О.Д., Архипова М.П., Строни Р. Оптимизация заживления раны после пластических хирургических операций. Акушерство и гинекология. 2011; 1: 89-94. [Radzinsky V.E., Petrova V.D., Khamoshina M.B., Salimova L.Ya., Rudneva O.D., Arkhipova MP, Stroni R. Optimization of wound healing after plastic surgery. Akusherstvo i Ginekologiya/Obstetrics and gynecology.2011; 1: 89-94. (in Russ.)].
- Календжян А.С., Хамошина М.Б., Шеленина Л.И., Петрова В.Д., Союнов М.А. Коррекция нарушений биоценоза влагалища после деструкции шейки матки. Доктор. Ру. Гинекология Эндокринология. 2015; 14 (115): 12-20. [Kalendzhyan A.S., Khamoshina M.B., Shelenina L.I., Petrova V.D., Soyunov M.A. Correction of vaginal biocenosis disorders after cervical destruction. Doctor. ru. Gynecology Endocrinology. 2015; 14 (115): 12-20. (in Russ.)].
- Обоскалова Т.А., Кононова И.Н., Ворошилина Е.С., Кузина Т.В. Эффективность реабилитационных мероприятий после деструктивных методов терапии у пациенток с патологией шейки матки, ассоциированной с папилломавирусной инфекцией Акушерство и гинекология. 2012; 2: 86-89. [Oboskalova T.A., Kononova I.N., Voroshilina E.S., Kuzina T.V. The effectiveness of rehabilitation measures after destructive methods of therapy in patients with cervical pathology associated with human papillomavirus infection. Akusherstvo i Ginekologiya/Obstetrics and gynecology. 2012; 2: 86-89. (in Russ.)].
- Савичева А.М., Спасибова Е.В., Шалепо К.В. Исследование чувствительности Streptococcus agalactiae, выделенных из урогенитального тракта, к действующим веществам, входящим в состав препарата Депантол. Российский вестник акушера-гинеколога. 2017; 6: 96-100. [Savicheva A.M., Spasibova E.V., Shalepo K.V. Investigation of the sensitivity of Streptococcus agalactiae isolated from the urogenital tract to the active substances included in the composition of Depantol. Russun bulletin of obstetrician-gynecologist. 2017; 6: 96-100. (in Russ.)].
- Кира Е.Ф., Рыбальченко О.В., Орлова О.Г., Коршакова Н.Ю. Изучение активности молочной кислоты in vitro и ее значение для клинической практики в лечении инфекций влагалища. Акушерство и гинекология. 2017; 11; 84-91. [Kira E.F., Rybalchenko O.V., Orlova O.G., Korshakova N.Yu. Investigation of the in vitro activity of lactic acid and its value for clinical practice in the treatment of vaginal infections. Obstetrics and gynecology. 2017; 11: 84-91. (in Russ.)].
- Фемилекс. Инструкция по медицинскому применению препарата, зарегистрированная Минздравом РФ (по grls.rosminzdrav.ru). Регистрационный номер ЛП-001689. [Femileks. Instructions for the medical use of the drug, registered by the Ministry of Health of the Russian Federation (by grls.rosminzdrav.ru). Registration number LP-001689. (in Russ.)].
- Хамошина М.Б., Тулупова М.С., Чотчаева А.И., Апресян С.В. Коррекция и профилактика нарушений биоценоза влагалища у беременных. Доктор. Ру.Гинекология. Эндокринология. 2012; 7 (75): 78-9. [Khamoshina M.B., Tulupova M.S., Chotchaeva A.I., Apresyan S.V. Correction and prevention of violations of the vaginal biocenosis in pregnant women. Doctor. RU. Gynecology. Endocrinology. 2012; 7 (75): 78-9. (in Russ.)].
- Гитман Т.А., Копосова О.В., Ворошилина Е.С. Состояние микробиоценоза влагалища по данным ПЦР в режиме реального времени у женщин с воспалительным типом мазка. Актуальные вопросы современной медицинской науки и здравоохранения. Сборник статей. 2019; 2: 39-43. [Gitman T.A., Koposova O.V., Voroshilina E.S. Vaginal microbiota composition based on the results of real-time PCR in women with inflammatory type smear. Current issues of modern medicine and healthcare. Digest of articles. 2019; 2: 39-43. (in Russ.)].
Received 10.06.2019
Accepted 21.06.2019
About the Authors
Radzinskiy Victor E., corresponding member of the Russian Academy of Science, MD, Professor, Head of the Department of obstetrics and gynecology with the course of Perinatology of the Medical Institute of the Peoples’ Friendship University of Russia. Tel.: +7(903)7232212, E-mail: radzinsky@mail.ru117198 Russia, Moscow, 6 Miklukho-Maklaya street.
Khamoshina Marina B., MD, Professor, Professor of the Department of obstetrics and gynecology with the course of Perinatology of the Medical Institute of the Peoples’ Friendship University of Russia. Tel.: +7(916)6091668. E-mail: khamoshina@mail.ru
117198 Russia, Moscow, 8 Miklukho-Maklaya street.
Orazov Mekan R., MD, Professor of the Department of obstetrics and gynecology with the course of Perinatology of the Medical Institute of the Peoples’ Friendship University of Russia. Tel.: +7(915)2375292. E-mail: omekan@mail.ru
117198 Russia, Moscow, 6 Miklukho-Maklaya street.
Tulupova Marina Sergeevna, Ph.D., chief physician of the Medical center Paracels LLC. Tel.: +7(902)5550806. E-mail: paracels.kdmc@yandex.ru
690005 Russia, Vladivostok, 4A Novoivanovskaya str.
Pestrikova Tatiana Yurievna - MD, Professor, Head of the Department of obstetrics and gynecology of the Far Eastern State Medical University.
Tel.: +7(914)7719383. E-mail: typ50@yandex.ru
680000 Russia, Khabarovsk, 35 Muravyeva-Amurskogo str.
Yarmolinskaya Maria Igorevna – MD, Professor of the Russian Academy of Science, Head of the Department of endocrinology of reproduction of the Research Institute of obstetrics, gynecology and reproduction named after D.O. Ott. Tel.: +7(921)916 69 03. E-mail: m.yarmolinskaya@gmail.com
199034 Russia, St. Petersburg, 3 Mendeleevskaya line.
Rymashevsky Alexander Nikolaevich – MD, Professor, Head of the Department of obstetrics and gynecology №1 of Rostov State Medical University of the Ministry of Health of the Russian Federation. Tel.: +7(863)2504072. E-mail: ryimashevski@list.ru
344022 Russia, Rostov-on-don, 29 Nakhichevansky lane.
For citation: Radzinskiy V.E., Khamoshina M.B., Orazov M.R., Tulupova M.S., Pestrikova T.Yu., Yarmolinskaya M.I., Rymashevsky A.N. Results of a multicenter observational study: therapy for acute non-specific and mixed vaginitis in reproductive-aged patients. Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2019; 8:150-58 (In Russian).
https://dx.doi.org/10.18565/aig.2019.8.150-158
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