Promoting increased compliance of managing patients with bacterial vaginosis

О. В. Грищенко, И. В. Лахно

Abstract


Bacterial vaginosis is a multiple infectious agents-associated epithelial pathology that captures local leukocyte reaction deficiency and the lack of humoral defense mechanisms of vaginal mucosa. The effective sanitation of vagina requires finding a combination of antiseptic substances that contribute to the destruction of the biofilm and improving the transport in the vaginal epithelium.

The study was aimed to the investigation of the efficacy of vaginal suppositories containing chlorhexidine and dexpanthenol (Depanthol, Stada) usage for the treatment of patients with bacterial vaginosis.

There were examined 142 patients of reproductive age who were divided into several clinical groups. In group I (control) 30 healthy women were included in the process of examination. In group II (comparison) 52 patients with bacterial vaginosis were monitored whom were administered metronidazole-containing vaginal suppositories once daily during the week. 60 women with bacterial vaginosis were enrolled in III (main) group those were treated with vaginal suppository Depanthol twice daily for 7 days.

The data demonstrated that in patients with bacterial vaginosis the prevalence of gardnerella and atopobium alliance with aerobic and anaerobic microorganisms, yeasts andprotozoa was found. Depanthol effectively influenced pathogens contributing to the reestablishment of the functional properties of vaginal mucosa. This contributed to the eradication of the main symbionts of vaginal biofilm – Gardnerella vaginalis and Atopobium vaginae and almost excluded the repeated episodes within six months of observation in the main group. The RR of the recurrence was 8.1 in group II (95% CI 1.1–58.4, sensitivity – 93.3%, specificity – 43.3%), and in group III the RR was 1.0 (95% CI 1.0–10.6, sensitivity – 66.7%, and specificity – 33.3%).


Keywords


bacterial vaginosis; treatment; Depanthol

References


Björklund, S., Pham, Q.D., Jensen, L.B., et al. “The effects of polar excipients transcutol and dexpanthenol on molecular mobility, permeability, and electrical impedance of the skin barrier.” J Colloid Interface Sci 479 (2016): 207–20.

Bradshaw, С.S., Tabrizi, S.N., Fairley, С.К., et al. “The association of Atopobium vaginae and Gardnerella vaginalis with bacterial vaginosis and recurrence after oral metronidazole therapy.” The Journal of infectious diseases 194.6 (2006): 828–36.

Carati, D., Zizza, A., Guido, M., et al. “Safety, efficacy, and tolerability of differential treatment to prevent and treat vaginal dryness and vulvovaginitis in diabetic women.” Clin Exp Obstet Gynecol 43.2 (2016): 198–202.

Ebner, F., Heller, A., Rippke, F., Tausch, I. “Topical use of dexpanthenol in skin disorders.” Am J Clin Dermatol 3 (2002): 427–33.

Gehring, W., Gloor, M. “Effect of topically applied dexpanthenol on epidermal barrier function and stratum corneum hydration. Results of a human in vivo study.” Arzneimittelforschung 50.7 (2000): 659–63.

Herrera, J.A., Chaudhuri, G., Lоpez-Jaramillo, P. “Is infection a major risk factor for preeclampsia?” Med Hypotheses 57.3 (2001): 393–7.

Lоpez-Jaramillo, P., Herrera, J.A., Arenas-Mantilla, M., et al. “Subclinical infection as a cause of inflammation in preeclampsia.” Am J Ther 15.4 (2008): 373–6.

Lopez-Lopez, J., Jan-Pallí, E., lez-Navarro, B.G., et al. “Efficacy of chlorhexidine, dexpanthenol, allantoin and chitosan gel in comparison with bicarbonate oral rinse in controlling post-interventional inflammation, pain and cicatrization in subjects undergoing dental surgery.” Curr Med Res Opin 31.12 (2015): 2179–83.

McDonald, H.M., Brocklehurst, P., Gordon, A. Antibiotics for treating bacterial vaginosis in pregnancy (Review). The Cochrane Library, John Wiley & Sons, Ltd. Issue 4 (2007): 64 р.

Molteni, B., D’Antuono, A., Bandini, P., et al. “Efficacy and tolerability of a new chlorhexidine-based vaginal gel in vaginal infections.” Curr Med Res Opin 20.6 (2004): 849–53.

Sherrard, J., Donders, G., White, D., et al. “European (IUSTI/WH) guideline on the management of vaginal discharge.” Int J STD AIDS 22.8 (2011): 421–29.

Sobel, J.D., Subramanian, C., Foxman, B., et al. “Mixed vaginitis – more than coinfection and with therapeutic implications.” Curr Infect Dis Rep 15 (2013): 104–8.

Wollina, U. “Conservative procedures in skin reconstitution.” GMS Curr Top Otorhinolaryngol Head Neck Surg 4 (2005): Doc 17.

Wollina, U., Nissen, H.P., Kubicki, J. “Antientzündliche Wirkungen von Dexpanthenol.” Akt Dermatol 30 (2004): 478–82.


GOST Style Citations


1. Björklund, S., Pham, Q.D., Jensen, L.B., et al. “The effects of polar excipients transcutol and dexpanthenol on molecular mobility, permeability, and electrical impedance of the skin barrier.” J Colloid Interface Sci 479 (2016): 207–20.

2. Bradshaw, С.S., Tabrizi, S.N., Fairley, С.К., et al. “The association of Atopobium vaginae and Gardnerella vaginalis with bacterial vaginosis and recurrence after oral metronidazole therapy.” The Journal of infectious diseases 194.6 (2006): 828–36.

3. Carati, D., Zizza, A., Guido, M., et al. “Safety, efficacy, and tolerability of differential treatment to prevent and treat vaginal dryness and vulvovaginitis in diabetic women.” Clin Exp Obstet Gynecol 43.2 (2016): 198–202.

4. Ebner, F., Heller, A., Rippke, F., Tausch, I. “Topical use of dexpanthenol in skin disorders.” Am J Clin Dermatol 3 (2002): 427–33.

5. Gehring, W., Gloor, M. “Effect of topically applied dexpanthenol on epidermal barrier function and stratum corneum hydration. Results of a human in vivo study.” Arzneimittelforschung 50.7 (2000): 659–63.

6. Herrera, J.A., Chaudhuri, G., Lоpez-Jaramillo, P. “Is infection a major risk factor for preeclampsia?” Med Hypotheses 57.3 (2001): 393–7.

7. Lоpez-Jaramillo, P., Herrera, J.A., Arenas-Mantilla, M., et al. “Subclinical infection as a cause of inflammation in preeclampsia.” Am J Ther 15.4 (2008): 373–6.

8. Lopez-Lopez, J., Jan-Pallí, E., lez-Navarro, B.G., et al. “Efficacy of chlorhexidine, dexpanthenol, allantoin and chitosan gel in comparison with bicarbonate oral rinse in controlling post-interventional inflammation, pain and cicatrization in subjects undergoing dental surgery.” Curr Med Res Opin 31.12 (2015): 2179–83.

9. McDonald, H.M., Brocklehurst, P., Gordon, A. Antibiotics for treating bacterial vaginosis in pregnancy (Review). The Cochrane Library, John Wiley & Sons, Ltd. Issue 4 (2007): 64 р.

10. Molteni, B., D’Antuono, A., Bandini, P., et al. “Efficacy and tolerability of a new chlorhexidine-based vaginal gel in vaginal infections.” Curr Med Res Opin 20.6 (2004): 849–53.

11. Sherrard, J., Donders, G., White, D., et al. “European (IUSTI/WH) guideline on the management of vaginal discharge.” Int J STD AIDS 22.8 (2011): 421–29.

12. Sobel, J.D., Subramanian, C., Foxman, B., et al. “Mixed vaginitis – more than coinfection and with therapeutic implications.” Curr Infect Dis Rep 15 (2013): 104–8.

13. Wollina, U. “Conservative procedures in skin reconstitution.” GMS Curr Top Otorhinolaryngol Head Neck Surg 4 (2005): Doc 17.

14. Wollina, U., Nissen, H.P., Kubicki, J. “Antientzündliche Wirkungen von Dexpanthenol.” Akt Dermatol 30 (2004): 478–82.





DOI: http://dx.doi.org/10.18370/2309-4117.2017.33.56-58

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ISSN 2411-1295 (Online), ISSN 2309-4117 (Print)