Бактериальный вагиноз (БВ) является самым распространенным нарушением микробиоценоза влагалища у женщин репродуктивного возраста. В обзоре представлены данные литературы относительно возможной роли БВ в нарушениях репродуктивной функции женщины, включая осложнения беременности, освещены современные методы диагностики этого заболевания, проанализированы особенности терапии БВ при беременности, а также обобщены результаты некоторых работ зарубежных и отечественных авторов по оценке разных схем терапии БВ.
Bacterial vaginosis (BV) is the most common vaginal disorder in women of reproductive age. This review presents literature data regarding a potential role of BV in adverse reproductive health outcomes, including pregnancy complications, describes current methods used for BV diagnosis, analyzes issues of treatment of this disease in pregnant women, and summarizes some works of foreign and Russian authors on evaluation of different BV therapy schemes.
1. Olmsted SS, Meyn LA, Rohan LC, Hillier SL. Glycosidase and proteinase activity of anaerobic gram-negative bacteria isolated from women with bacterial vaginosis. Sex Transm Dis 2003; 30 (3): 257–61.
2. Koumans EH, Sternberg M, Bruce C et al. The prevalence of bacterial vaginosis in the United States, 2001–2004: associations with symptoms, sexual behaviors, and reproductive health. Sex Transm Dis 2007; 34: 864–9.
3. Wilson J. Managing recurrent bacterial vaginosis. Sex Transm Infect 2004; 80 (1): 8–11.
4. Bradshaw CS, Morton AN, Hocking J et al. High recurrence rates of bacterial vaginosis over the course of 12 months after oral metronidazole therapy and factors associated with recurrence. J Infect Dis 2006; 193:1478–86.
5. Spiegel CA. Bacterial vaginosis. Rev Med Microbiol 2002; 13: 43–51.
6. Verstraelen H, Verhelst R, Claeys G et al. Culture-independent analysis of vaginal microflora: the unrecognized association of Atopobium vaginae with bacterial vaginosis. Am J Obstet Gynecol 2004; 191: 1130–2.
7. Fredricks DN, Fiedler TL, Marrazzo JM. Molecular identification of bacteria associated with bacterial vaginosis. N Engl J Med 2005; 353: 1899–911.
8. Zozaya-Hinchliffe M, Martin DH, Ferris MJ. Prevalence and abundance of uncultivated Megasphaera-like bacteria in the human vaginal environment. Appl Environ Microbiol 2008; 74: 1656–9.
9. Schwebke JR, Weiss HL. Interrelationships of bacterial vaginosis and cervical inflammation. Sex Transm Dis 2002; 29: 59–64.
10. Wiesenfeld HC, Hillier SL, Krohn MA et al. Bacterial vaginosis is a strong predictor of Neisseria gonorrhoeae and Chlamydia trachomatis infection. Clin Infect Dis 2003; 36: 663–8.
11. Allsworth JE, Peipert JF. Severity of bacterial vaginosis and the risk of sexually transmitted infection. Am J Obstet Gynecol 2011; 205 (2): 113.e1–6.
12. Cherpes TL, Meyn LA, Krohn MA et al. Association between acquisition of herpes simplex virus type 2 in women and bacterial vaginosis. Clin Infect Dis 2003; 37: 319–25.
13. Myer L, Kuhn L, Stein ZA et al. Intravaginal practices, bacterial vaginosis, and women’s susceptibility to HIV infection: epidemiological evidence and biological mechanisms. Lancet Infect Dis 2005; 5: 786–94.
14. Sweet RL. Role of bacterial vaginosis in pelvic inflammatory disease. Clin Infect Dis 1995; 20 (Suppl. 2): S271–5.
15. Hillier SL, Kiviat NB, Hawes SE et al. Role of bacterial vaginosis-associated microorganisms in endometritis. Am J Obstet Gynecol 1996; 175: 435–41.
16. Wiesenfeld H, Hillier S, Krohn M et al. Lower genital tract infection and endometritis: Insight into subclinical pelvic inflammatory disease. Obstet Gynecol 2002; 100: 456–63.
17. Haggerty CL, Hillier SL, Bass DC, Ness RB. Bacterial vaginosis and anaerobic bacteria are associated with endometritis. Clin Infect Dis 2004; 39: 990–5.
18. Ralph SG, Rutherford AJ, Wilson JD. Influence of bacterial vaginosis on conception and miscarriage in the first trimester: cohort study. BMJ 1999; 319: 220–3.
19. McGregor JA, French JI, Jones W et al. Bacterial vaginosis is associated with prematurity and vaginal fluid mucinase and sialidase: results of a controlled trial of topical clindamycin cream. Am J Obstet Gynecol 1994; 170: 1048–59.
20. Hay PE, Lamont RF, Taylor-Robinson D et al. Abnormal bacterial colonisation of the genital tract and subsequent preterm delivery and late miscarriage. BMJ 1994; 308: 295–8.
21. Kurki T, Sivonen A, Renkonen OV et al. Bacterial vaginosis in early pregnancy and pregnancy outcome. Obstet Gynecol 1992; 80: 173–7.
22. Lamont RF, Taylor-Robinson D, Newman M et al. Spontaneous early preterm labour associated with abnormal genital bacterial colonization. Br J Obstet Gynaecol 1986; 93: 804–10.
23. Hillier SL, Nugent RP, Eschenbach DA et al. Association between bacterial vaginosis and preterm delivery of a low-birth-weight infant. The Vaginal Infections and Prematurity Study Group. N Engl J Med 1995; 333: 1737–42.
24. Silver HM, Sperling RS, St Clair PJ, Gibbs RS. Evidence relating bacterial vaginosis to intraamniotic infection. Am J Obstet Gynecol 1989; 161: 808–12.
25. Hillier SL, Martius J, Krohn M et al. A case-control study of chorioamnionic infection and histologic chorioamnionitis in prematurity. N Engl J Med 1988; 319: 972–8.
26. Martius J, Eschenbach DA. The role of bacterial vaginosis as a cause of amniotic fluid infection, chorioamnionitis and prematurity – a review. Arch Gynecol Obstet 1990; 247: 1–13.
27. Watts DH, Krohn MA, Hillier SL, Eschenbach DA. Bacterial vaginosis as a risk factor for post-cesarean endometritis. Obstet Gynecol 1990; 75: 52–8.
28. Korn AP, Bolan G, Padian N et al. Plasma cell endometritis in women with symptomatic bacterial vaginosis. Obstet Gynecol 1995; 85: 387–90.
29. Khatamee MA, Sommers SC. Clinicopathologic diagnosis of mycoplasma endometritis. Int J Fertil 1989; 34: 52–5.
30. Bennett BB, Clark P, Riley P et al. The association of asymptomatic bacterial vaginosis with upper genital tract infection. Prim Care Update Ob Gyns 1998; 5 (4): 150.
31. Bhattacharjee B, Herrington CS, Sunderland D, Birley HD. Scanning electron microscopy of endometrial biopsies of patients with bacterial vaginosis shows morphology resembling mycoplasma/ureaplasma organisms. Sex Transm Infect 1999; 75: 202.
32. Keelan JA, Blumenstein M, Helliwell RJ et al. Cytokines, prostaglandins and parturition–a review. Placenta 2003; (24 suppl. A): S33–S46.
33. Cauci S, Thorsen P, Schendel DE et al. Determination of immunoglobulin A against Gardnerella vaginalis hemolysin, sialidase, and prolidase activities in vaginal fluid: implications for adverse pregnancy outcomes. J Clin Microbiol 2003; 41: 435–8.
34. Macones GA, Parry S, Elkousy M et al. A polymorphism in the promoter region of TNF and bacterial vaginosis: preliminary evidence of gene-environment interaction in the etiology of spontaneous preterm birth. Am J Obstet Gynecol 2004; 190: 1504–8.
35. Савичева А.М., Башмакова М.А., Красносельских Т.В. и др. Лабораторная диагностика бактериального вагиноза. СПб.: Н-Л, 2011.
36. Workowski KA, Berman S. Centers for Disease Control and Prevention. Sexually transmitted diseases treatment guidelines, 2010. MMWR Recomm Rep 2010; 59: 1–110.
37. Amsel R, Totten PA, Spiegel CA et al. Nonspecific vaginitis. Diagnostic criteria and microbial and epidemiologic associations. Am J Med 1983; 74: 14–22.
38. Nugent RP, Krohn MA, Hillier SL. Reliability of diagnosing bacterial vaginosis is improved by a standardized method of gram stain interpretation. J Clin Microbiol 1991; 29: 297–301.
39. Ison CA, Hay PE. Validation of a simplified grading of Gram stained vaginal smears for use in genitourinary medicine clinics. Sex Transm Infect 2002; 78 (6): 413–5.
40. WHO. Sexually transmitted and other reproductive tract infections. A guide to essential practice. Annex 3. Laboratory tests for STI, 2005.
41. Европейские стандарты диагностики и лечения заболеваний, передающихся половым путем. М.: Медицинская литература, 2004.
42. Акушерство и гинекология – клинические рекомендации. Под ред. Г.М.Савельевой, В.Н.Серова, Г.Т.Сухих. 3-е изд. 2011.
43. Goldstein EJ, Citron DM, Merriam CV et al. In vitro activities of Garenoxacin (BMS 284756) against 108 clinical isolates of Gardnerella vaginalis. Antimicrob Agents Chemother 2002; 46: 3995–6.
44. Xiao JC, Xie LF, Fang SL et al. Symbiosis of Mycoplasma hominis in Trichomonas vaginalis may link metronidazole resistance in vitro. Parasitol Res 2006; 100: 123–30.
45. Ferris MJ, Masztal A, Aldridge KE et al. Association of Atopobium vaginae, a recently described metronidazole resistant anaerobe, with bacterial vaginosis. BMC Infect Dis 2004; 4: 5.
46. De Backer E, Dubreuil L, Brauman M et al. In vitro activity of secnidazole against Atopobium vaginae, an anaerobic pathogen involved in bacterial vaginosis. Clin Microbiol Infect 2010; 16: 470–2.
47. Donders GG, Van Calsteren K, Bellen G et al. Predictive value for preterm birth of abnormal vaginal flora, bacterial vaginosis and aerobic vaginitis during the first trimester of pregnancy. BJOG 2009; 116: 1315–24.
48. Workowski KA, Berman SM. Centers for Disease Control and Prevention sexually transmitted diseases treatment guidelines. Clin Infect Dis 2007; 44 (Suppl. 3): S73–6.
49. Spiegel CA, Eschenbach DA, Amsel R, Holmes KK. Curved anaerobic bacteria in bacterial (nonspecific) vaginosis and their response to antimicrobial therapy. J Infect Dis 1983; 148: 817–22.
50. Spiegel CA. Susceptibility of Mobiluncus species to 23 antimicrobial agents and 15 other compounds. Antimicrob Agents Chemother 1987; 31: 249–52.
51. Barry AL, Thornsberry C, Jones RN. In vitro activity of a new macrolide, A-56268, compared with that of roxithromycin, erythromycin, and clindamycin. Antimicrob Agents Chemother 1987; 31: 343–5.
52. Hillier S, Krohn MA, Watts DH et al. Microbiologic efficacy of intravaginal clindamycin cream for the treatment of bacterial vaginosis. Obstet Gynecol 1990; 76: 407–13.
53. Zambrano D. Clindamycin in the treatment of obstetric and gynecologic infections: a review. Clin Ther 1991; 13: 58–80.
54. Toma E, Fournier S, Poisson M et al. Clindamycin with primaquine for Pneumocystis carinii pneumonia. Lancet 1989; 1: 1046–8.
55. Rolston KV, Hoy J. Role of clindamycin in the treatment of central nervous system toxoplasmosis. Am J Med 1987; 83: 551–4.
56. Ugwumadu A, Manyonda I, Reid F, Hay P. Effect of early oral clindamycin on late miscarriage and preterm delivery in asymptomatic women with abnormal vaginal flora and bacterial vaginosis: a randomised controlled trial. Lancet 2003; 361: 983–8.
57. Soper DE. Clindamycin. Obstet Gynecol Clin North Am 1992; 19: 483–96.
58. Mylonakis E, Ryan ET, Calderwood SB. Clostridium difficile – associated diarrhea: a review. Arch Intern Med 2001; 161: 525–33.
59. Miller AM, Bassett ML, Dahlstrom JE, Doe WF. Antibiotic-associated haemorrhagic colitis. J Gastroenterol Hepatol 1998; 13: 1115–8.
60. McFarland LV. Antibiotic-associated diarrhea: epidemiology, trends and treatment. Future Microbiol 2008; 3: 563–78.
61. Borin MT, Powley GW, Tackwell KR, Batts DH. Absorption of clindamycin after intravaginal application of clindamycin phosphate 2% cream. J Antimicrob Chemother 1995; 35: 833–41.
62. Lamont RF, Jones BM, Mandal D et al. The efficacy of vaginal clindamycin for the treatment of abnormal genital tract flora in pregnancy. Infect Dis Obstet Gynecol 2003; 11: 181–9.
63. Lamont RF, Nhan-Chang CL, Sobel JD et al. Treatment of abnormal vaginal flora in early pregnancy with clindamycin for the prevention of spontaneous preterm birth: a systematic review and metaanalysis. Am J Obstet Gynecol 2011; 205 (3): 177–90.
64. Егорова А.Т., Базина М.И., Рулева М.А. Опыт лечения бактериального вагиноза у беременных женщин клиндацином (крем вагинальный). Рос. вестн. акушера-гинеколога 2010; 6: 68–71.
65. Шеманаева Т.В., Хосева Е.Н. Нарушения микробиоценоза влагалищной флоры у беременных на разных сроках гестации и особенности их коррекции. Гинекология 2011; 13 (6): 36–40.
66. Шеманаева Т.В. Опыт применения свечей клиндацина в лечении беременных с бактериальным вагинозом. Рос. вестн. акушера-гинеколога 2011; 4: 87–9.
67. Новиков Б.Н., Тец В.В. Клиническая эффективность препарата Клиндацин при лечении бактериального вагиноза у беременных. Рациональная фармакотерапия в акушерстве и гинекологии. Рук. для практикующих врачей. Под общ. ред. В.И.Кулакова, В.Н.Серова. М.: Литтера, 2007; с. 237–40.
68. Байрамова Г.Р., Прилепская В.Н., Цаллагова Е.В. Оценка эффективности и безопасности применения препарата «Клиндацин» в терапии больных с бактериальным вагинозом. Гинекология 2006; 8 (5–6): 14–6.
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1. Olmsted SS, Meyn LA, Rohan LC, Hillier SL. Glycosidase and proteinase activity of anaerobic gram-negative bacteria isolated from women with bacterial vaginosis. Sex Transm Dis 2003; 30 (3): 257–61.
2. Koumans EH, Sternberg M, Bruce C et al. The prevalence of bacterial vaginosis in the United States, 2001–2004: associations with symptoms, sexual behaviors, and reproductive health. Sex Transm Dis 2007; 34: 864–9.
3. Wilson J. Managing recurrent bacterial vaginosis. Sex Transm Infect 2004; 80 (1): 8–11.
4. Bradshaw CS, Morton AN, Hocking J et al. High recurrence rates of bacterial vaginosis over the course of 12 months after oral metronidazole therapy and factors associated with recurrence. J Infect Dis 2006; 193:1478–86.
5. Spiegel CA. Bacterial vaginosis. Rev Med Microbiol 2002; 13: 43–51.
6. Verstraelen H, Verhelst R, Claeys G et al. Culture-independent analysis of vaginal microflora: the unrecognized association of Atopobium vaginae with bacterial vaginosis. Am J Obstet Gynecol 2004; 191: 1130–2.
7. Fredricks DN, Fiedler TL, Marrazzo JM. Molecular identification of bacteria associated with bacterial vaginosis. N Engl J Med 2005; 353: 1899–911.
8. Zozaya-Hinchliffe M, Martin DH, Ferris MJ. Prevalence and abundance of uncultivated Megasphaera-like bacteria in the human vaginal environment. Appl Environ Microbiol 2008; 74: 1656–9.
9. Schwebke JR, Weiss HL. Interrelationships of bacterial vaginosis and cervical inflammation. Sex Transm Dis 2002; 29: 59–64.
10. Wiesenfeld HC, Hillier SL, Krohn MA et al. Bacterial vaginosis is a strong predictor of Neisseria gonorrhoeae and Chlamydia trachomatis infection. Clin Infect Dis 2003; 36: 663–8.
11. Allsworth JE, Peipert JF. Severity of bacterial vaginosis and the risk of sexually transmitted infection. Am J Obstet Gynecol 2011; 205 (2): 113.e1–6.
12. Cherpes TL, Meyn LA, Krohn MA et al. Association between acquisition of herpes simplex virus type 2 in women and bacterial vaginosis. Clin Infect Dis 2003; 37: 319–25.
13. Myer L, Kuhn L, Stein ZA et al. Intravaginal practices, bacterial vaginosis, and women’s susceptibility to HIV infection: epidemiological evidence and biological mechanisms. Lancet Infect Dis 2005; 5: 786–94.
14. Sweet RL. Role of bacterial vaginosis in pelvic inflammatory disease. Clin Infect Dis 1995; 20 (Suppl. 2): S271–5.
15. Hillier SL, Kiviat NB, Hawes SE et al. Role of bacterial vaginosis-associated microorganisms in endometritis. Am J Obstet Gynecol 1996; 175: 435–41.
16. Wiesenfeld H, Hillier S, Krohn M et al. Lower genital tract infection and endometritis: Insight into subclinical pelvic inflammatory disease. Obstet Gynecol 2002; 100: 456–63.
17. Haggerty CL, Hillier SL, Bass DC, Ness RB. Bacterial vaginosis and anaerobic bacteria are associated with endometritis. Clin Infect Dis 2004; 39: 990–5.
18. Ralph SG, Rutherford AJ, Wilson JD. Influence of bacterial vaginosis on conception and miscarriage in the first trimester: cohort study. BMJ 1999; 319: 220–3.
19. McGregor JA, French JI, Jones W et al. Bacterial vaginosis is associated with prematurity and vaginal fluid mucinase and sialidase: results of a controlled trial of topical clindamycin cream. Am J Obstet Gynecol 1994; 170: 1048–59.
20. Hay PE, Lamont RF, Taylor-Robinson D et al. Abnormal bacterial colonisation of the genital tract and subsequent preterm delivery and late miscarriage. BMJ 1994; 308: 295–8.
21. Kurki T, Sivonen A, Renkonen OV et al. Bacterial vaginosis in early pregnancy and pregnancy outcome. Obstet Gynecol 1992; 80: 173–7.
22. Lamont RF, Taylor-Robinson D, Newman M et al. Spontaneous early preterm labour associated with abnormal genital bacterial colonization. Br J Obstet Gynaecol 1986; 93: 804–10.
23. Hillier SL, Nugent RP, Eschenbach DA et al. Association between bacterial vaginosis and preterm delivery of a low-birth-weight infant. The Vaginal Infections and Prematurity Study Group. N Engl J Med 1995; 333: 1737–42.
24. Silver HM, Sperling RS, St Clair PJ, Gibbs RS. Evidence relating bacterial vaginosis to intraamniotic infection. Am J Obstet Gynecol 1989; 161: 808–12.
25. Hillier SL, Martius J, Krohn M et al. A case-control study of chorioamnionic infection and histologic chorioamnionitis in prematurity. N Engl J Med 1988; 319: 972–8.
26. Martius J, Eschenbach DA. The role of bacterial vaginosis as a cause of amniotic fluid infection, chorioamnionitis and prematurity – a review. Arch Gynecol Obstet 1990; 247: 1–13.
27. Watts DH, Krohn MA, Hillier SL, Eschenbach DA. Bacterial vaginosis as a risk factor for post-cesarean endometritis. Obstet Gynecol 1990; 75: 52–8.
28. Korn AP, Bolan G, Padian N et al. Plasma cell endometritis in women with symptomatic bacterial vaginosis. Obstet Gynecol 1995; 85: 387–90.
29. Khatamee MA, Sommers SC. Clinicopathologic diagnosis of mycoplasma endometritis. Int J Fertil 1989; 34: 52–5.
30. Bennett BB, Clark P, Riley P et al. The association of asymptomatic bacterial vaginosis with upper genital tract infection. Prim Care Update Ob Gyns 1998; 5 (4): 150.
31. Bhattacharjee B, Herrington CS, Sunderland D, Birley HD. Scanning electron microscopy of endometrial biopsies of patients with bacterial vaginosis shows morphology resembling mycoplasma/ureaplasma organisms. Sex Transm Infect 1999; 75: 202.
32. Keelan JA, Blumenstein M, Helliwell RJ et al. Cytokines, prostaglandins and parturition–a review. Placenta 2003; (24 suppl. A): S33–S46.
33. Cauci S, Thorsen P, Schendel DE et al. Determination of immunoglobulin A against Gardnerella vaginalis hemolysin, sialidase, and prolidase activities in vaginal fluid: implications for adverse pregnancy outcomes. J Clin Microbiol 2003; 41: 435–8.
34. Macones GA, Parry S, Elkousy M et al. A polymorphism in the promoter region of TNF and bacterial vaginosis: preliminary evidence of gene-environment interaction in the etiology of spontaneous preterm birth. Am J Obstet Gynecol 2004; 190: 1504–8.
35. Савичева А.М., Башмакова М.А., Красносельских Т.В. и др. Лабораторная диагностика бактериального вагиноза. СПб.: Н-Л, 2011.
36. Workowski KA, Berman S. Centers for Disease Control and Prevention. Sexually transmitted diseases treatment guidelines, 2010. MMWR Recomm Rep 2010; 59: 1–110.
37. Amsel R, Totten PA, Spiegel CA et al. Nonspecific vaginitis. Diagnostic criteria and microbial and epidemiologic associations. Am J Med 1983; 74: 14–22.
38. Nugent RP, Krohn MA, Hillier SL. Reliability of diagnosing bacterial vaginosis is improved by a standardized method of gram stain interpretation. J Clin Microbiol 1991; 29: 297–301.
39. Ison CA, Hay PE. Validation of a simplified grading of Gram stained vaginal smears for use in genitourinary medicine clinics. Sex Transm Infect 2002; 78 (6): 413–5.
40. WHO. Sexually transmitted and other reproductive tract infections. A guide to essential practice. Annex 3. Laboratory tests for STI, 2005.
41. Европейские стандарты диагностики и лечения заболеваний, передающихся половым путем. М.: Медицинская литература, 2004.
42. Акушерство и гинекология – клинические рекомендации. Под ред. Г.М.Савельевой, В.Н.Серова, Г.Т.Сухих. 3-е изд. 2011.
43. Goldstein EJ, Citron DM, Merriam CV et al. In vitro activities of Garenoxacin (BMS 284756) against 108 clinical isolates of Gardnerella vaginalis. Antimicrob Agents Chemother 2002; 46: 3995–6.
44. Xiao JC, Xie LF, Fang SL et al. Symbiosis of Mycoplasma hominis in Trichomonas vaginalis may link metronidazole resistance in vitro. Parasitol Res 2006; 100: 123–30.
45. Ferris MJ, Masztal A, Aldridge KE et al. Association of Atopobium vaginae, a recently described metronidazole resistant anaerobe, with bacterial vaginosis. BMC Infect Dis 2004; 4: 5.
46. De Backer E, Dubreuil L, Brauman M et al. In vitro activity of secnidazole against Atopobium vaginae, an anaerobic pathogen involved in bacterial vaginosis. Clin Microbiol Infect 2010; 16: 470–2.
47. Donders GG, Van Calsteren K, Bellen G et al. Predictive value for preterm birth of abnormal vaginal flora, bacterial vaginosis and aerobic vaginitis during the first trimester of pregnancy. BJOG 2009; 116: 1315–24.
48. Workowski KA, Berman SM. Centers for Disease Control and Prevention sexually transmitted diseases treatment guidelines. Clin Infect Dis 2007; 44 (Suppl. 3): S73–6.
49. Spiegel CA, Eschenbach DA, Amsel R, Holmes KK. Curved anaerobic bacteria in bacterial (nonspecific) vaginosis and their response to antimicrobial therapy. J Infect Dis 1983; 148: 817–22.
50. Spiegel CA. Susceptibility of Mobiluncus species to 23 antimicrobial agents and 15 other compounds. Antimicrob Agents Chemother 1987; 31: 249–52.
51. Barry AL, Thornsberry C, Jones RN. In vitro activity of a new macrolide, A-56268, compared with that of roxithromycin, erythromycin, and clindamycin. Antimicrob Agents Chemother 1987; 31: 343–5.
52. Hillier S, Krohn MA, Watts DH et al. Microbiologic efficacy of intravaginal clindamycin cream for the treatment of bacterial vaginosis. Obstet Gynecol 1990; 76: 407–13.
53. Zambrano D. Clindamycin in the treatment of obstetric and gynecologic infections: a review. Clin Ther 1991; 13: 58–80.
54. Toma E, Fournier S, Poisson M et al. Clindamycin with primaquine for Pneumocystis carinii pneumonia. Lancet 1989; 1: 1046–8.
55. Rolston KV, Hoy J. Role of clindamycin in the treatment of central nervous system toxoplasmosis. Am J Med 1987; 83: 551–4.
56. Ugwumadu A, Manyonda I, Reid F, Hay P. Effect of early oral clindamycin on late miscarriage and preterm delivery in asymptomatic women with abnormal vaginal flora and bacterial vaginosis: a randomised controlled trial. Lancet 2003; 361: 983–8.
57. Soper DE. Clindamycin. Obstet Gynecol Clin North Am 1992; 19: 483–96.
58. Mylonakis E, Ryan ET, Calderwood SB. Clostridium difficile – associated diarrhea: a review. Arch Intern Med 2001; 161: 525–33.
59. Miller AM, Bassett ML, Dahlstrom JE, Doe WF. Antibiotic-associated haemorrhagic colitis. J Gastroenterol Hepatol 1998; 13: 1115–8.
60. McFarland LV. Antibiotic-associated diarrhea: epidemiology, trends and treatment. Future Microbiol 2008; 3: 563–78.
61. Borin MT, Powley GW, Tackwell KR, Batts DH. Absorption of clindamycin after intravaginal application of clindamycin phosphate 2% cream. J Antimicrob Chemother 1995; 35: 833–41.
62. Lamont RF, Jones BM, Mandal D et al. The efficacy of vaginal clindamycin for the treatment of abnormal genital tract flora in pregnancy. Infect Dis Obstet Gynecol 2003; 11: 181–9.
63. Lamont RF, Nhan-Chang CL, Sobel JD et al. Treatment of abnormal vaginal flora in early pregnancy with clindamycin for the prevention of spontaneous preterm birth: a systematic review and metaanalysis. Am J Obstet Gynecol 2011; 205 (3): 177–90.
64. Егорова А.Т., Базина М.И., Рулева М.А. Опыт лечения бактериального вагиноза у беременных женщин клиндацином (крем вагинальный). Рос. вестн. акушера-гинеколога 2010; 6: 68–71.
65. Шеманаева Т.В., Хосева Е.Н. Нарушения микробиоценоза влагалищной флоры у беременных на разных сроках гестации и особенности их коррекции. Гинекология 2011; 13 (6): 36–40.
66. Шеманаева Т.В. Опыт применения свечей клиндацина в лечении беременных с бактериальным вагинозом. Рос. вестн. акушера-гинеколога 2011; 4: 87–9.
67. Новиков Б.Н., Тец В.В. Клиническая эффективность препарата Клиндацин при лечении бактериального вагиноза у беременных. Рациональная фармакотерапия в акушерстве и гинекологии. Рук. для практикующих врачей. Под общ. ред. В.И.Кулакова, В.Н.Серова. М.: Литтера, 2007; с. 237–40.
68. Байрамова Г.Р., Прилепская В.Н., Цаллагова Е.В. Оценка эффективности и безопасности применения препарата «Клиндацин» в терапии больных с бактериальным вагинозом. Гинекология 2006; 8 (5–6): 14–6.
Авторы
А.М.Савичева, Е.В.Шипицына
Лаборатория микробиологии ФБГУ Научно-исследовательский институт акушерства и гинекологии им. Д.О.Отта СЗО РАМН, Санкт-Петербург