On the prospects for the use of spiramycin and secnidazole in obstetrics and gynecology

DOI

https://dx.doi.org/10.18565/aig.2026.14

Gromovа O.A., Tetruashvili N. K., TorshinI.Yu.
1) Federal Research Center “Computer Science and Control” of the Russian Academy of Sciences, Moscow, Russia; 2) Academician V.I. Kulakov National Medical Research Centre for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia, Moscow, Russia

The paper presents the results of the systematization of 1,755 publications on the pharmacology of spiramycin which is a macrolide antibiotic known for its minimal resistance as many strains remain susceptible to it. Spiramycin blocks protein synthesis by interacting with three binding sites on bacterial ribosomes. The efficacy of spiramycin is due to its triple pharmacodynamic effect, namely antibiotic, bactericidal and post-antibiotic, which persists after the end of treatment. Spiramycin has a good safety profile that is especially important for antibiotic therapy during pregnancy. This is due to its targeted accumulation in the tissues of the uterus and genitourinary system. It is the safety of spiramycin that determines the success of its use for the treatment of toxoplasmosis of pregnant women and for the prevention of transmission of the Toxoplasma gondii parasite from the pregnant woman to the fetus. The effectiveness and safety of spiramycin against oral pathogens causing caries, gingivitis and periodontitis has been demonstrated.
Spiramycin is an effective treatment for upper and lower respiratory tract infections, which can be particularly severe during pregnancy. This medication is highly effective in the treatment of urinary tract infections caused by chlamydia and ureaplasma. Spiramycin has promising potential for use in the treatment of chlamydia and non-gonococcal urethritis, especially in combination with secnidazole that has a good efficacy and safety profile compared to other 5-nitroimidazoles (metronidazole, tinidazole). Anti-inflammatory, anti-atherosclerotic, antineoplastic and other additional effects of spiramycin (e.g., anti-obesity effect) have been established. Spiramycin does not cause serious concomitant toxicity or does not contribute to increased magnesium loss, nor does it affect the metabolism of B vitamins. Therefore, unlike many other antibiotics, spiramycin is not a risk factor for life-threatening conditions such as prolongation of the QT interval on the ECG and paroxysmal ventricular tachycardia. Spiramycin does not stimulate the development of resistance in bacterial pathogens. These pharmacological effects make this medication even more important for the inhibition and eradication of bacterial strains that are resistant to other antibiotics.
Conclusion. Spiramycin (Doramitcin WM), as a macrolide with a favorable safety profile, for pregnancy as well, and low antibiotic resistance, and secnidazole (Secnidox), as 5 nitroimidazole with its convenient single-dose regimen and minimal effect on the normal vaginal microflora, can be considered as rational components of therapy, in particular in mixed urogenital infections (for example, mixed vaginitis).

Authors’ contributions: Gromova O.A., Tetruashvili N.K. – developing the concept and design of the article; Torshin I.Yu. – collecting and processing the materials, processing the statistical data; Gromova O.A., Torshin I.Yu. – writing the text; Tetruashvili N.K. – editing the article.
Conflicts of interest: The authors declare that there are no conflicts of interest.
Funding: The study was conducted without sponsorship.
For citation: Gromovа O.A., Tetruashvili N.K., Torshin I.Yu.
Prospects for the use of spiramycin and secnidazole in obstetrics and gynecology.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2026; (1): 104-119 (in Russian)
https://dx.doi.org/10.18565/aig.2026.14

antibiotic therapy for pregnant women

efficacy and safety

pharmacoinformatics

Doramitcin WM

Secnidox

Full text (in Russian)

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Указ Президента РФ «О Стратегии развития здравоохранения в Российской Федерации» на период до 2030 года 8 декабря 2025 года №896. Доступно по: https://www.garant.ru/products/ipo/prime/doc/413121153/ [Decree of the President of the Russian Federation «On the Strategy for the Development of Healthcare in the Russian Federation» for the period up to 2030 December 8, 2025 No. 896. Available at: https://www.garant.ru/products/ipo/prime/doc/413121153/ (in Russian)].

Received 19.01.2025

Accepted 29.01.2025

Olga A. Gromova, Dr. Med. Sci., Professor, Leading Researcher, Federal Research Center “Computer Science and Control” of RAS, 44 bldg. 2 Vavilov str., Moscow, 119333, Russia, unesco.gromova@gmail.com, Scopus Author ID: 7003589812, WoS ResearcherID: J-4946-2017, RSCI SPIN-code: 6317-9833, https://orcid.org/0000-0002-7663-710X
Nana K. Tetruashvili, Dr. Med. Sci., Head of the Department of Pregnancy Loss Prevention and Therapy, Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia, 4 Ac. Oparina str., Moscow, 117997, Russia, tetrauly@mail.ru, https://orcid.org/0000-0002-9201-2281
Ivan Yu. Torshin, PhD (Phys. Math.), PhD (Chem.), Senior Researcher, Federal Research Center “Computer Science and Control” of RAS, 44 bldg. 2, Vavilov str., Moscow, 119333, Russia, tiy135@yahoo.com, Scopus Author ID: 7003300274, WoS ResearcherID: C-7683-2018, RSCI SPIN-code: 1375-1114, https://orcid.org/0000-0002-2659-7998
Corresponding author: Olga A. Gromova, unesco.gromova@gmail.com

On the prospects for the use of spiramycin and secnidazole in obstetrics and gynecology

Gromovа O.A., Tetruashvili N. K., TorshinI.Yu.

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