Local therapy as a modern trend in the treatment of vaginal infections
Keywords:infectious and inflammatory vaginal diseases, vaginitis, antibiotic resistance, topical therapy, Gynodek®
Infectious-inflammatory diseases of the vagina (vaginitis) are a problem with serious social and economic consequences around the world. Vaginitis varies depending on their origin; they are divided into infectious and non-infectious. Non-infectious vaginitis develops in the absence of an infectious agent. They can cause thermal, chemical, mechanical and allergic factors. Bacterial factors may join to the inflammatory process later. To this group belongs atrophic vaginitis too. Infectious vaginitis includes bacterial vaginosis, nonspecific vaginitis, candida vaginitis, gonorrheal vaginitis, trichomonas vaginitis.
The abundance of therapeutic regimens used in the treatment of infectious and inflammatory vaginal diseases indicates on their low therapeutic efficacy. Thus, long-term antibiotic treatment of chronic vulvovaginitis changes endogenous flora, increases number of resistant strains to antibacterial drugs. That is why most researchers indicate on a central role of integrated management, including a general and local therapy. In particular, highly effective in the vaginitis treatment showed combined local drugs with complex work: it has antibacterial, antifungal and antiviral effect, help to restore the “positive” microflora balance, as well as eliminate the dryness of the external genitalia, recovers mucosa, has anti-inflammatory properties.
Today special attention is attracted by modern local drug Gynodek® in the form of a vaginal gel, which has been successfully used in recent years for the topical treatment and prevention of vaginal infections.
In a case of persistent, acute vaginitis should be used topical antibiotics based on its susceptibility. In the final stage drugs for restoration of the natural vaginal flora and increasing its protective properties are used. To control the cure in women of reproductive age swabs are taken for 4–5-th day of menstruation, and after treatment in girls and women in menopause. In order to prevent recurrences the local therapy should be repeated after 4–5 months.
- Savicheva, A.M., Sokolovskiy, E.V., Domeika, M. Short guidelines on the microscopic diagnosis of sexually transmitted diseases. St. Petersburg. Foliant (2004): 128 p.
- Petersen, E.E. Infections in Obstetrics and Gynecology: texbook and atlas. New York. Thieme (2006): 260 p.
- Romanik, M., Wojciechowska-Wieja, A., Martirosian, G. “Aerobic vaginitis – diagnostic problems and treatment.” Ginekol Pol 78.6 (2007): 488–91.
- Repina, M.A., Safronova, M.M. “New in the treatment of vulvovaginal in reproductive period.” Reproduction Problems 3 (1955): 56–8.
- Serova, O.F., Zarochentseva, N.V., Menshikova, N.S. “Bacterial vaginosis treatment and prevention.” Gynecology, Obstetrics and Perinatology Questions 8.1 (2009): 84–6.
- Strizhakov, A.N., Budanov, P.V. “Vaginal microcenosis status and correction methods of its disorders during pregnancy.” Gynecology, Obstetrics and Perinatology Questions 5.6 (2007): 90–3.
- Lebedev, V.A., Pashkov, V.M., Sechenova, I.M. “Modern principles of colpites therapy.” Difficult Patient 8–9 (2011).
- Karapetyan, T.E., Tyutyunnik, V.L., Mikhailova, O.I., Medzhidova, M.K. “Modern concepts and basic principles of the treatment of nonspecific vaginitis.” Russian Medical Journal 1 (2012): 24. 9. Kisina, V.I., Zabirov, K.I. Urogenital infections in women. Moscow. MIA (2005): 276 p.
- Linhares, I.M., Giraldo, P.C., Baracat, E.C. “New findings about vaginal bacterial flora.” Rev Assoc Med Bras 56.3 (2010): 370–4.
- Serov, V.N. “Prevention of complications of pregnancy and childbirth.” Russian Medical Journal 2.16 (2003): 889-92.
- Radzinskiy, V.E., Ordiyants, I.M. Two-stage therapy of vaginal infections. Moscow. Editorial Board of the Status Praesens Journal (2012): 16 p.
- Serov, V.N., Shapovalenko, S.A. “Vaginal microbiocenosis and infectious vulvovaginitis: a rational choice of drug for therapy.” Gynecology, Obstetrics and Perinatology Questions 3.4 (2004): 27–31.
- Austin, M.N., et al. “Microbiogical response to treatment of bacterial vaginosis with topical clindamycin or metronidazole.” J Clin Microbiol 43 (2005): 4492–7.
- Bischof, P., Lauber, K., de Wurstemberger, B., Girard, J.P. “Inhibition of lymphocyte transformation by pregnancy-associated plasma protein-A (PAPP-A).” J Clin Lab Immunol 7.1 (1982): 61–5.
- Brocklehurst, P., Carney, O., Ross, E., Mindel, A. “The management of reccurent genital herpes infection in pregnancy: a postal survey of obstetric practice.” Brit J Obstet Gynaec 102 (2005): 791–4.
- Tempera, G., Furneri, P.M. “Management of aerobic vaginitis.” Gynecol Obstet Invest 70.4 (2010): 244–9.
- Medyannikova, I.V. “Evaluating the effectiveness of immunotherapy at colpites and cervicitis.” Gynecology, Obstetrics and Perinatology Questions 7.3 (2008): 43–7.
- Pinegin, B.V., Nekrasov, A.V., Khaitov, R.M. “Immunomodulator Polioxidony: mechanisms of action and aspects of the clinical use.” Cytokines and Inflammation 3.3 (2004): 41–7.
- The World Health Organization. The growing threat of antimicrobial resistance. Possible measures (2013). Available from: [http://apps.who.int/iris/bitstre am/10665/ 44812/16/9789244503188_rus.pdf], last accessed Aug 08, 2016.
- Workowski, K.A., Berman, S.M., Douglas, J.M. “Emerging antimicrobial resistance in Neisseria gonorrhoeae: urgent need to strengthen prevention strategies.” Ann Internal Med 148.8 (2008): 606–13.
- Tapsall, J.W., et al. “Meeting the public health challenge of multidrug- and extensively drug-resistant Neisseria gonorrhoeae.” Exp Rev of Anti-Infective Ther 7.7 (2009): 821–34.
- Centers for Disease Control and Prevention. “Cephalosporin susceptibility among Neisseria gonorrhoeae isolates – United States, 2000–2010.” Morbidity and Mortality Weekly Report (MMWR) 60.26 (2011): 873–7.
- Tapsall, J., et al. “Two cases of failed ceftriaxone treatment in pharyngeal gonorrhoea verified by molecular microbiological methods.” J Med Microbiol 58.5 (2009): 683–7.
- Ershov, G.V., et al. “Inflammatory diseases of the pelvic organs.” Clinical microbiology and Antimicrobial Chemotherapy 6.2 (2004).
- Kozlov, R.S. “Selection of resistant organisms when using antimicrobial drugs: the concept of «parallel damage».” Clinical microbiology and Antimicrobial Chemotherapy 12.4 (2010).
- Kira, E.F., Muslimova, S.Z. “The nonspecific vaginitis and its impact on women’s reproductive health.” Reproduction Problems 5 (2008): 8–14.
- Mashburn, J. “Etiology, diagnosis, and management of vaginitis.” J Midwifery Women’s Health 51.6 (2006): 423–30.
- Quan, M. “Vaginitis: diagnosis and management.” Postgrad Med 122.6 (2010): 117–27. 30. Gynodek®. Инструкция по применению. Gynodek®. Instruction for use.
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