DOI: https://doi.org/10.18370/2309-4117.2019.50.18-21

Modern tendency of prevention and treatment of infectious processes of the lower genital tract

В. І. Пирогова, С. О. Шурпяк

Abstract


Issue of the treatment of mixed genital infections and prevention of reproductive health disorders caused by them has not lost medical and social significance, which is associated with a high frequency of mixed infections, absence of pathognomonic clinical manifestations, and with a constantly significant frequency of sexually transmitted infections (chlamydia, genital herpes, trichomoniasis, etc.). It should be controlled and rationally limited antibiotics use in connection with a sharp increase in microorganisms’ resistance. At the same time proven antiseptics which are used to reduce the infection risk or to treat vaginal infections do not contribute to the formation of resistant pathogens.

The purpose of this literature review was to analyze publications about modern antiseptic octenidine dihydrochloride for mucous membranes, skin and wounds and the prospects for it use in obstetric and gynecological practice.

Octenidine dihydrochloride (octenidine) was synthesized as a multi-functional antiseptic for skin, mucous membranes and wounds. Today octenidine is an active antiseptic with a wide scope of use and is an alternative to chlorhexidine, povidone iodine, triclosan, etc. Octenidine is a cationic antiseptic of a new chemical group (derivatives of bispyridinamine), is a safe and effective antimicrobial agent with a high level and spectrum of antimicrobial activity. The antiseptic activity of octenidine is achieved within 30 seconds, it is chemically resistant, has proven low toxicity to humans and the environment and high clinical efficacy, does not cause the pathogen resistance, is approved for use from the second trimester in pregnancy and during breastfeeding. Octenidine use with or without combinations should be considered as an integral part of the standard therapy for various types of vaginitis and bacterial vaginosis. Octenidine can become a promising agent for therapeutic indications in gynecology in future, since it surpasses povidone iodine, polyhexanide and chlorhexidine in the efficiency of microorganisms’ eradication from the mucous membranes.

Keywords


antiseptic; bacterial vaginosis; vaginitis; octenidine dihydrochloride; prophylaxis; Prodexin

References


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Sidorova, I.S., Borovkova, E.I. “The results of a comparative study of the effectiveness of local drugs in the treatment of non-specific inflammatory diseases of the vagina.” Russian herald of obstetrician-gynecologist 3 (2007): 63–6.

Alvarez-Marin, R., Aires-de-Sousa, M., Nordmann, P., et al. “Antimicrobial activity of octenidine against multidrug-resistant Gram-negative pathogens.” Eur J Clin Microbiol Infect Dis 36 (2017): 2379–83. doi: 10.1007/s10096-017-3070-0

Behrends, S., Siebert, J., Golombiewski, M., et al. Antimikrobielle Zubereitungen mit einem Gehalt an Octenidindihydrochlorid verkapselt in Liposomen. Patent No DE 102005063375A1. 2007. PCT/EP2006066282. 2008.

Conceição, T., de Lencastre, H., Aires-de-Sousa, M. “Efficacy of octenidine against antibiotic-resistant Staphylococcus aureus epidemic clones.” J Antimicrob Chemother 71.10 (2016): 2991–4.

European Committee on Antimicrobial Susceptibility Testing (EUCAST). Breakpoint tables for interpretation of MICs and zone diameters. Version 6.0 (2016). Available from: [http://www.eucast.org/fileadmin/src/media/PDFs/EUCAST_files/Breakpoint_tables/v_6.0_Breakpoint_table.pdf], last accessed Dec 22, 2019.

Friese, К. “Topical antiseptics as an alternative in the treatment of acute vulvovaginal candidosis.” Arch Gynecol Obstet 268.3 (2003): 194–7.

Goroncy-Bermes, P., Brill, F.H.H., Brill, H. “Antimicrobial activity of wound antiseptics against extended-spectrum β-lactamase producing bacteria.” Wound Med 1 (2013): 41–3.

Hubner, N.O., Siebert, J., Kramer, A. “Octenidine dihydrochloride, a modern antiseptic for skin, mucous membranes and wounds.” Skin Pharmacol Physiol 23 (2010): 244–58.

Kampf, G. “The value of using chlorhexidine soap in a controlled trial to eradicate MRSA in colonized patients.” J Hosp Infect 58 (2004): 86.

Koban, I., Bender, C.P., Assadian, O., et al. “Clinical use of the antiseptic polihexanide for genital tract infections.” Skin Pharmacol Physiol 25 (2012): 298–304.

Kramer, A., Adrian, V., Rudolph, P., et al. “Explant test with skin and peritoneum of the neonatal rat as a predictive test of tolerance of local anti-infective agents in wounds and body cavities.” Chirurg 69 (1998): 840–5.

Kramer, A., Assadian, O., Mіller, G., et al. “Octenidine, chlorhexidine, iodine and iodophores, with introductory chapter antisepsis.” In: Kramer, A., Assadian, O., eds: Wallhdussers Praxis der Sterilisation, Desinfektion, Antiseptik und Konservierung, ed. 1, reprint. Stuttgart. Thieme (2008).

Krishna, B.V., Gibb, A.P. “Use of octenidine dihydrochloride in meticillinresistant Staphylococcus aureus decolonisation regimens: a literature review.” J Hosp Infect 74 (2010): 199–203.

Krug, B., Dabek, S., Müller, K.M., et al. Wund- und Schleimhautdesinfektionsmittel. Patent No DE 102005058978A1. 2007.

Küng, E. “In vitro effect of octenidine dihydrochloride against Trichomonas vaginalis.” International Journal of Antimicrobial Agents 47 (2016): 232–4.

Laxminarayan, R., Duse, A., Wattal, C., et al. “Antibiotic resistance – the need for global solutions.” Lancet Infect Dis 13.12 (2013): 1057–98.

Menke, H., Pelzer, M., Raff, T., et al. “Ein neues lokales Antiseptikum zur Oberflдchenbehandlung bei Schwerstverbrannten.” Akt Traumatol 31 (2001): 211–5.

Nordmann, P., Poirel, L. “The difficult-to-control spread of carbapenemase producers among Enterobacteriaceae worldwide.” Clin Microbiol Infect 20.9 (2014): 821–30.

Novakov Mikic, A., Stojic, S. “Study results on the use of different therapies for the treatment of vaginitis in hospitalised pregnant women.” Arch Gynecol Obstet 292.2 (2015): 371–6. doi: 10.1007/s00404-015-3638-9

Novakov Mikic, A., Budakov, D. “Comparison of local metronidazole and a local antiseptic in the treatment of bacterial vaginosis.” Arch Gynecol Obstet 282.1 (2010): 43–7.

Pitten, F.A., Werner, H.P., Kramer, A. “A standardized test to assess the impact of different organic challenges on the antimicrobial activity of antiseptics.” J Hosp Infect 55.2 (2003): 108–15.

Robert Koch-Institut. “Hygienemaßnahmen bei Infektionen oder Besiedlung mit multiresistenten gramnegativen Stäbchen. Empfehlung der Kommission für Krankenhaushygiene und Infektionsprävention (KRINKO) beim Robert Koch-Institut (RKI).” Bundesgesundheitsbl 55 (2012): 1311–54.

Sopata, M., Ciupinska, M., Glowacka, A., et al. “Effect of octenisept antiseptic on bioburden of neoplastic ulcers in patients with advanced cancer.” J Wound Care 17 (2008): 24–7.

Swidsinski, A. “Polymicrobial Gardnerella biofilm resists repeated intravaginal antiseptic treatment in a subset of women with bacterial vaginosis: a preliminary report.” Arch Gynecol Obstet 291.3 (2015): 605–9. doi: 10.1007/s00404-014-3484-1

Tietz, A., Frei, R., Dangel, M., et al. “Octenidine hydrochloride for the care of central venous catheter insertion sites in severely immunocompromised patients.” Infect Control Hosp Epidemiol 26 (2005): 703–7.

Yudin, M.H., Money, D.M. “Screening and management of bacterial vaginosis in pregnancy.” J Obstet Gynaecol Can 30.8 (2008): 702–16.

Friese, K. “Vergleich zweier lokaler Antiseptika in der klinichen Anwendung bei bakteriell bedingten Vaginalinfektionen.” Geburtsh Frauenheilk 60 (2000): 308–13.


GOST Style Citations


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5.         Conceição, T., de Lencastre, H., Aires-de-Sousa, M. “Efficacy of octenidine against antibiotic-resistant Staphylococcus aureus epidemic clones.” J Antimicrob Chemother 71.10 (2016): 2991–4.

6.         European Committee on Antimicrobial Susceptibility Testing (EUCAST). Breakpoint tables for interpretation of MICs and zone diameters. Version 6.0 (2016). Available from: [http://www.eucast.org/fileadmin/src/media/PDFs/EUCAST_files/Breakpoint_tables/v_6.0_Breakpoint_table.pdf], last accessed Dec 22, 2019.

7.         Friese, К. “Topical antiseptics as an alternative in the treatment of acute vulvovaginal candidosis.” Arch Gynecol Obstet 268.3 (2003): 194–7.

8.         Goroncy-Bermes, P., Brill, F.H.H., Brill, H. “Antimicrobial activity of wound antiseptics against extended-spectrum β-lactamase producing bacteria.” Wound Med 1 (2013): 41–3.

9.         Hubner, N.O., Siebert, J., Kramer, A. “Octenidine dihydrochloride, a modern antiseptic for skin, mucous membranes and wounds.” Skin Pharmacol Physiol 23 (2010): 244–58.

10.       Kampf, G. “The value of using chlorhexidine soap in a controlled trial to eradicate MRSA in colonized patients.” J Hosp Infect 58 (2004): 86.

11.       Koban, I., Bender, C.P., Assadian, O., et al. “Clinical use of the antiseptic polihexanide for genital tract infections.” Skin Pharmacol Physiol 25 (2012): 298–304.

12.       Kramer, A., Adrian, V., Rudolph, P., et al. “Explant test with skin and peritoneum of the neonatal rat as a predictive test of tolerance of local anti-infective agents in wounds and body cavities.” Chirurg 69 (1998): 840–5.

13.       Kramer, A., Assadian, O., Mіller, G., et al. “Octenidine, chlorhexidine, iodine and iodophores, with introductory chapter antisepsis.” In: Kramer, A., Assadian, O., eds: Wallhdussers Praxis der Sterilisation, Desinfektion, Antiseptik und Konservierung, ed. 1, reprint. Stuttgart. Thieme (2008).

14.       Krishna, B.V., Gibb, A.P. “Use of octenidine dihydrochloride in meticillinresistant Staphylococcus aureus decolonisation regimens: a literature review.” J Hosp Infect 74 (2010): 199–203.

15.       Krug, B., Dabek, S., Müller, K.M., et al. Wund- und Schleimhautdesinfektionsmittel. Patent No DE 102005058978A1. 2007.

16.       Küng, E. “In vitro effect of octenidine dihydrochloride against Trichomonas vaginalis.” International Journal of Antimicrobial Agents 47 (2016): 232–4.

17.       Laxminarayan, R., Duse, A., Wattal, C., et al. “Antibiotic resistance – the need for global solutions.” Lancet Infect Dis 13.12 (2013): 1057–98.

18.       Menke, H., Pelzer, M., Raff, T., et al. “Ein neues lokales Antiseptikum zur Oberflдchenbehandlung bei Schwerstverbrannten.” Akt Traumatol 31 (2001): 211–5.

19.       Nordmann, P., Poirel, L. “The difficult-to-control spread of carbapenemase producers among Enterobacteriaceae worldwide.” Clin Microbiol Infect 20.9 (2014): 821–30.

20.       Novakov Mikic, A., Stojic, S. “Study results on the use of different therapies for the treatment of vaginitis in hospitalised pregnant women.” Arch Gynecol Obstet 292.2 (2015): 371–6. doi: 10.1007/s00404-015-3638-9

21.       Novakov Mikic, A., Budakov, D. “Comparison of local metronidazole and a local antiseptic in the treatment of bacterial vaginosis.” Arch Gynecol Obstet 282.1 (2010): 43–7.

22.       Pitten, F.A., Werner, H.P., Kramer, A. “A standardized test to assess the impact of different organic challenges on the antimicrobial activity of antiseptics.” J Hosp Infect 55.2 (2003): 108–15.

23.       Robert Koch-Institut. “Hygienemaßnahmen bei Infektionen oder Besiedlung mit multiresistenten gramnegativen Stäbchen. Empfehlung der Kommission für Krankenhaushygiene und Infektionsprävention (KRINKO) beim Robert Koch-Institut (RKI).” Bundesgesundheitsbl 55 (2012): 1311–54.

24.       Sopata, M., Ciupinska, M., Glowacka, A., et al. “Effect of octenisept antiseptic on bioburden of neoplastic ulcers in patients with advanced cancer.” J Wound Care 17 (2008): 24–7.

25.       Swidsinski, A. “Polymicrobial Gardnerella biofilm resists repeated intravaginal antiseptic treatment in a subset of women with bacterial vaginosis: a preliminary report.” Arch Gynecol Obstet 291.3 (2015): 605–9. doi: 10.1007/s00404-014-3484-1

26.       Tietz, A., Frei, R., Dangel, M., et al. “Octenidine hydrochloride for the care of central venous catheter insertion sites in severely immunocompromised patients.” Infect Control Hosp Epidemiol 26 (2005): 703–7.

27.       Yudin, M.H., Money, D.M. “Screening and management of bacterial vaginosis in pregnancy.” J Obstet Gynaecol Can 30.8 (2008): 702–16.

28.       Friese, K. “Vergleich zweier lokaler Antiseptika in der klinichen Anwendung bei bakteriell bedingten Vaginalinfektionen.” Geburtsh Frauenheilk 60 (2000): 308–13.





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