Evaluation of clinical efficacy and tolerance of minocycline in women with bacterial-associated chronic endometritis
Kononova I.N., Dobrokhotova Yu.E., Kareva E.N., Lunina S.N., Narimanova M.R., Ogurtsova T.A.
The high prevalence of reproductive failures in frequently recurring chronic endometritis (CE) with high resistance to antibacterial therapy was a precondition for the search for new effective safe drugs.
Objective. Evaluation of the clinical efficacy and safety of minocycline (Minolexin, capsules for oral administration, JSC AVVA RUS, Russia) in patients with bacterial-associated CE.
Materials and methods. We conducted examination and treatment of 63 patients with bacterial-associated chronic endometriosis. The endometrial and vaginal microbiota were studied using microbiological (culture) methods, as well as real-time PCR (RT-PCR) with the FLOROSKRIN, NCMT, and PCR for HPV, HSV I and II. Immunohistochemical analysis of syndecan-1 (CD138) expression was performed using endometrial biopsy material (pipeline biopsy). An ultrasound examination of the pelvic organs with the analysis of the endometrium was carried out. Patients in the 1st group (n=32) received the antibacterial drug "Minolexin" (minocycline 100 mg) 2 times a day for 10 days + the antifungal prebiotic "Ecofucin" 1 suppository 1 time per day intravaginally for 6 days. Patients in the control group (n=31) received the antibacterial drug "Doxycycline" 100 mg 2 times a day for 10 days + the antifungal prebiotic "Ecofucin" 1 suppository 1 time per day intravaginally for 6 days. Minolexin tolerability was assessed 5 and 10 days later using a visual analogue scale (VAS). Clinical efficacy was evaluated 30 days after initiation of treatment using pelvic ultrasound, microbiological (culture) testing, RT-PCR of endometrial contents, and CD138 testing from endometrial biopsy material. Long-term outcomes for the CE recurrence were estimated 60 days later.
Results. As a result of antibacterial therapy for CE, positive changes in key clinical, laboratory and instrumental research methods were demonstrated in both groups: in 96.8% (31/32) and 90.3% (28/31) in groups 1 and 2, respectively. However, according to the ultrasound results, the absence of CE signs was observed in 84.4% (27/32) of patients in group 1 and in 64.5% (20/31) in group 2. Recurrence of chronic endometriosis 60 days after the treatment was recorded in 6.25% (2/32) and 19.3% (6/31) of patients in groups 1 and 2, respectively. These results can be explained by better absorption in the gastrointestinal tract, compared to doxycycline, due to its higher (5-fold) lipophilicity, as well as better penetration through the thickened lipid layer of microorganism membranes.
Conclusion. Due to its high clinical efficacy with a low level of side effects and high adherence to therapy, Minolexin, a systemic antibiotic of the tetracycline group, can be the first-line antibacterial therapy for patients with bacterial-associated CE.
Authors’ contributions. Kononova I.N., Kareva E.N. – study concept and design; Lunina S.N., Narimanova M.R.,
Ogurtsova T.A. – material collection and processing; Kononova I.N., Lunina S.N. – statistical data processing, manuscript writing; Dobrokhotova Yu.E. – manuscript editing.
Conflicts of interest. The authors declare no conflict of interest.
Funding. The study was conducted without sponsorship.
Ethical Approval. The study was approved by the local ethics committee of the Pirogov Russian National Research Medical University of the Ministry of Health of Russia.
Generative Artificial Intelligence. No generative AI technologies were used for the conduction of the study.
Patient Consent for Publication. All patients provided informed consent for the publication of their data.
Authors' Data Sharing Statement. The data supporting the findings of this study are available on request from the corresponding author after approval from the principal investigator.
For citation: Kononova I.N., Dobrokhotova Yu.E., Kareva E.N., Lunina S.N., Narimanova M.R., Ogurtsova T.A. Evaluation of clinical efficacy and tolerance of minocycline in women with bacterial-associated chronic endometritis.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2026; (9): 138-146 (in Russian)
https://dx.doi.org/10.18565/aig.2026.221
Keywords
chronic endometritis
antibacterial therapy
minocycline
Minolexin
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Received 15.07.2026
Accepted 04.09.2026
About the Authors
Irina N. Kononova, Dr. Med. Sci., Department of Obstetrics and Gynecology, Pirogov Russian National Research Medical University, Ministry of Health of the Russian Federation, 1 Ostrovityanova str., Moscow, 117997, Russia; Deputy Director, Interregional Center for Additional Professional Education, +7(904)382-41-16,irkonmed@mail.ru, https://orcid.org/0000-0003-3483-9464
Yuliya E. Dobrokhotova, Dr. Med. Sci., Professor, Honored Doctor of RF, Head of the Department of Obstetrics and Gynaecology, Faculty of General Medicine,
Pirogov Russian National Research Medical University, Ministry of Health of the Russian Federation, 1 Ostrovityanova str., Moscow, 117997, Russia, pr. dobrohotova@mail.ru,
https://orcid.org/0000-0003-2786-6181
Elena N. Kareva, Dr. Med. Sci., Professor at the Department of Molecular Pharmacology and Radiobiology named after Academician P.V. Sergeev, Pirogov Russian National Research Medical University, Ministry of Health of the Russian Federation, 1 Ostrovityanova str., Moscow, 117997, Russia; Professor at the Department of Pharmacology, Faculty of General Medicine, I.M. Sechenov First Moscow State Medical University, Ministry of Health of the Russian Federation (Sechenov University), +7(499)246-60-05, elenakareva@mail.ru
Metanat R. Narimanova, PhD, Associate Professor, Department of Obstetrics and Gynecology, Pirogov Russian National Research Medical University, Ministry of Health of the Russian Federation, 1 Ostrovityanova str., Moscow, 117997, Russia, +7(926)275-84-80, safarovametanat@yandex.ru, https://orcid.org/0000-0003-0677-2952
Svetlana N. Lunina, PhD, Associate Professor, Department of Obstetrics and Gynecology, Pirogov Russian National Research Medical University, Ministry of Health of the Russian Federation, 1 Ostrovityanova str., Moscow, 117997, Russia, +7(910)461-77-88, svetlana.lunina2011@yandex.ru, https://orcid.org/0009-0008-5467-4701
Tatiana A. Ogurtsova, obstetrician-gynecologist of the highest category, Yekaterinburg Сlinical Perinatal Сenter, 9 Komsomolskaya str., Yekaterinburg, 620137, Russia, +7(343)304-63-32, mail@ekpc.ru, https://orcid.org/0000-0001-6180-0288
Corresponding author: Irina N. Kononova, irkonmed@mail.ru
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