Associated with atopobium vaginae bacterial vaginosis: modern principles of diagnosis and therapy

Abstract

Molecular biology techniques have shown that not all vaginal biotope microorganisms have been identified previously, which may play a role in the development of bacterial vaginosis. One of the previously undetectable by culture methods for diagnosis of vaginal microbial biotope is Atopobium vaginae.

5-nitroimidazoles drugs and clindamycin are currently used in the bacterial vaginosis treatment according to the current national and international recommendations. Studies showed that A. vaginae often resistant to metronidazole, being sensitive to only one of the recommended drugs clindamycin.

The study of efficacy and safety of the hexicon drug (vaginal suppositories) in treatment optimization of bacterial vaginosis that associated with A. vaginae was performed, compared with the efficacy and safety of traditional therapy (metronidazole, clindamycin).

The study included 60 women who were randomized in 3 groups according to treatment: in I group were 20 patients who underwent therapy with metronidazole gel 0.75%; group II include 20 patients who used clindamycin cream 2%; group III include 20 patients who underwent hexicon treatment.

Therapy effectiveness evaluated with clinical and laboratory examination, including assessment of the bacterial vaginosis symptoms according to Amsel’s criteria, evaluation of lactobacilli component of the vaginal microflora and A. vaginae identification.

Clinical and laboratory efficacy for vaginal suppositories hexicon in the treatment of bacterial vaginosis associated with A. vaginae was 95%, which is comparable to the drug of choice clindamycin (95%) and exceeded for metronidazole (80%). A. vaginae eradication therapy with hexicon was comparable with clindamycin (95 and 95% respectively) and significantly higher than for metronidazole (95 and 65%). The normal rate of vaginal lactobacilli microbiocenosis after treatment with hexicon were observed in 70% of patients, after clindamycin treatment – in 40%, and after metronidazole treatment – in 15% of patients. Hexicon had high safety and tolerability.