Modern approaches to prediction and treatment of recurrent bacterial vaginosis and combined dysbiosis of the vagina and urinary tract

DOI

https://dx.doi.org/10.18565/aig.2025.250

Dikke G.B., Bebneva T.N.
1) F.I. Inozemtsev Academy of Medical Education, St. Petersburg, Russia; 2) Patrice Lumumba Peoples’ Friendship University of Russia, Moscow, Russia; 3) I.I. Dedov National Medical Research Center for Endocrinology, Ministry of Health of Russia, Moscow, Russia

The prevalence of bacterial vaginosis (BV) is 23–29%. There is a high frequency of recurrent and combined forms of BV with bacterial-viral infections and urinary tract infections that cause difficulties in diagnosis and choice of the treatment. It is necessary to develop new pathogenetic approaches for the prevention of recurrent BV (RBV), treatment of RBV and combined infections.
BV-associated and aerobic species of bacteria and fungi trigger an innate immune response in the lower genital tract which is characterized by the activation of pro-inflammatory cytokines. These cytokines remain at high levels if the effect of treatment is not sufficient. A correlation was found between the likelihood of recurrence and a high concentration of the anti-inflammatory cytokine IL-4 in the vaginal discharge after treatment of an episode of the disease. The determination of IL-4 concentration in vaginal swabs after treatment may be used as a predictor for disease recurrence. The comprehensive treatment of patients with RBV and its combined forms using a complex of antimicrobial peptides and cytokines (AMPC), namely Superlymph, has a high clinical efficacy characterized by the elimination of opportunistic microorganisms, cessation of virus secretion, normalization of cytokine balance, and a decrease in the frequency of relapses. According to the concept of two-stage treatment, the use of a medication containing L. acidophilus at least 107 and a complex of proteins, cytokines, vitamins and minerals (cream dosed in suppositories, Acylact DUO) is effective in the prevention of relapses after treatment of an episode of BV.
Conclusion: The AMPC complex, when used locally, has an immunomodulatory effect that helps to reduce the frequency of recurrent BV and other infections of the urogenital tract. The medication containing L. acidophilus and a complex of proteins, cytokines, vitamins and minerals, is effective in preventing relapses after an episode of BV.

Authors’ contributions: Dikke G.B., Bebneva T.N. – developing the concept and design, search for literary sources and collection of material, analysis of publications and interpretation of their results, writing the text. Both authors contributed equally to the preparing and writing of the article. Dikke G.B. – editing the article after review.
Conflicts of interest: Authors declare lack of the possible conflicts of interest.
Funding: No funding was provided for this research. The authors carried out the research at their own expense. The publication of the article was supported by Biotechpharm LLC.
For citation: Dikke G.B., Bebneva T.N. Modern approaches to prediction and treatment of
recurrent bacterial vaginosis and combined dysbiosis of the vagina and urinary tract.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2025; (9): 56-68 (in Russian)
https://dx.doi.org/10.18565/aig.2025.250

microbiota

bacterial vaginosis

candidal vulvovaginitis

aerobic vaginitis

dysbiosis

combined bacterial and viral infections

urinary tract infections

relapses

immunity

cytokines

immunomodulators

antimicrobial peptides and cytokines

Superlymph

Acylact DUO

Full text (in Russian)

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Received 09.09.2025

Accepted 12.09.2025

Galina B. Dikke, Dr. Med. Sci., Associate Professor, Professor at the Department of Obstetrics and Gynecology with the Course of Reproductive Medicine,
F.I. Inozemtsev Academy of Medical Education, 190013, Russia, St. Petersburg, Moskovsky Ave., 22, litera M, galadikke@yandex.ru, https://orcid.org/0000-0001-9524-8962
Tamara N. Bebneva, Dr. Med. Sci., Associate Professor at the Department of Obstetrics, Gynecology and Reproductive Medicine, Faculty of Continuous Medical Education, Medical Institute, Patrice Lumumba Peoples’ Friendship University of Russia, 117198, Russia, Moscow, Miklukho-Maklaya str., 6; obstetrician-gynecologist,
Academician I.I. Dedov National Medical Research Center of Endocrinology, Ministry of Health of Russia, 117292, Russia, Moscow, Dmitry Ulyanov str., 11,
bebn@mail.ru, https://orcid.org/0000-0003-1095-2008
Corresponding author: Galina B. Dikke, galadikke@yandex.ru

Modern approaches to prediction and treatment of recurrent bacterial vaginosis and combined dysbiosis of the vagina and urinary tract

Dikke G.B., Bebneva T.N.

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