Инфекционно-воспалительные заболевания гениталий, вызываемые разными условно-патогенными и патогенными микроорганизмами, обнаруживаются у 70% всех гинекологических больных, обращающихся за помощью в медицинские учреждения. В настоящее время ученые и клиницисты все чаще сталкиваются с недостаточной эффективностью лечения вульвовагинитов и вагинозов, их склонностью к длительному и затяжному течению, рецидивированием процесса. Одной из причин более длительного и тяжелого течения, рецидивирования процесса является смешанная инфекция с возможным одновременным преобладанием аэробов, анаэробов, грибов рода Candida, что предполагает назначение препаратов комплексного действия. К одним из таких препаратов относится Тержинан, который обладает хорошей клинической эффективностью и переносимостью при лечении рецидивирующих вульвовагинитов и дисбиотических состояний нижних половых путей.
Infectious and inflammatory diseases of the genitals caused by various opportunistic and pathogenic microorganisms arefound in 70% of all gynecological patients who seek help from medical institutions. Currently, scientists and clinicians in their practice are increasingly faced with insufficient effectiveness of treatment of vulvovaginitis and vaginosis, a tendency to a long and protracted course, recurrence of the process. One of the reasons for the longer and more severe course, the recurrence of the process is the increasingly common mixed infection with the possible simultaneous predominance of aerobes, anaerobes, and Candida fungi, which suggests the appointment of appropriate drugs. One of these drugs is Tergynan, which demonstrates a good clinical effect and tolerability of the drug in the treatment of recurrent vulvovaginitis and dysbiotic conditions of the lower genital tract.
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1. Hildebrand JP, Kansagor AT. Vaginitis. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2020. https://www.ncbi.nlm.nih.gov/books/NBK470302
2. Mulu W, Yimer M, Zenebe Y, Abera B. Common causes of vaginal infections and antibiotic susceptibility of aerobic bacterial isolates in women of reproductive age attending at Felegehiwot Referral Hospital, Ethiopia: a cross sectional study. BMC Womens Health 2015; 15: 42. DOI: 10.1186/s12905-015-0197-y
3. Kaambo E, Africa CW. The threat of aerobic vaginitis to pregnancy and neonatal morbidity. Afr J Reprod Health 2017; 21 (2): 109–18. DOI: 10.29063/ajrh2017/v21i2.12
4. Lamichhane P, Joshi D, Subedi Y et al. Study on types of vaginitis and association between bacterial vaginosis and urinary tract infection in pregnant women. Int J Biomed Adv Res 2014; 5 (6): 305–7. DOI: 10.7439/ijbar.v5i6.762
5. Prilepskaya V.N. Vaginal infections and local preparations of complex action. Gynecology. 2011; 13 (6) (in Russian).
6. Strizhakov A.N., Davydov A.I., Belotserkovtseva L.D. Profilaktika i preventivnaia terapiia infektsionnykh oslozhnenii vlagalishchnoi i vnutrimatochnoi khirurgii. Voprosy ginekologii, akusherstva i perinatologii. 2014; 13 (2): 63–7 (in Russian).
7. Makarov I.O., Borovkova E.I. Bacterial and viral infections in obstetrics and gynecology: a tutorial. Moscow: MEDpress-inform, 2013 (in Russian).
8. Kaambo E, Africa C, Chambuso R, Passmore JS. Vaginal Microbiomes Associated With Aerobic Vaginitis and Bacterial Vaginosis. Front Public Health 2018; 6: 78. DOI: 10.3389/fpubh.2018.00078
9. Anahtar MN, Gootenberg DB, Mitchell CM, Kwon DS. Cervicovaginal Microbiota and Reproductive Health: The Virtue of Simplicity. Cell Host Microbe 2018; 23 (2): 159–68.
10. Prilepskaya V.N., Kira E.F., Gomberg M.A. et al. Federal clinical guidelines. Diagnostics and treatment of diseases accompanied by pathological discharge from the genital tract of women. Moscow, 2019 (in Russian).
11. Tansarli GS, Kostaras EK, Athanasiou S, Falagas ME. Prevalence and treatment of aerobic vaginitis among non-pregnant women: evaluation of the evidence for an underestimated clinical entity. Eur J Clin Microbiol Infect Dis 2013; 32 (8): 977–84. DOI: 10.1007/s10096-013-1846-4.
12. Voroshilina E.S., Tumbinskaia L.V., Donnikov A.E. et al. Biotsenoz vlagalishcha s tochki zreniia kolichestvennoi PTsR: chto est' norma? Akusherstvo i ginekologiia. 2011; 1: 57 (in Russian).
13. Verboon-Maciolek MA, Gerards LJ, Stoutenbeek P, van Loon AM. Congenital infection: diagnostic serology of the mother not always definitive. Ned Tijdschr Geneeskd 2001; 145 (4): 153–6.
14. Wang L, Tong Z, Wang Z et al. Single-center retrospective study of the incidence of, and risk factors for, non-C. albicans invasive candidiasis in hospitalized patients in China. Med mycol 2014; 52 (2): 115–22.
15. Yapar N. Epidemiology and risk factors for invasive candidiasis. Ther Clin Risk Manag 2014; 10: 95–105.
16. Coudray MS, Madhivanan P. Bacterial Vaginosis – A Brief Synopsis of the Literature. Eur J Obstet Gynecol Reprod Biol 2019; 245.
17. Bradshaw CS, Sobel JD. Current Treatment of Bacterial Vaginosis-Limitations and Need for Innovation. J Infect Dis 2016; 214 (1): 14–20.
18. Menukhova Iu.N. Bakterial'nyi vaginoz: etiopatogenez, kliniko-laboratornye osobennosti. Zhurn. akusherstva i zhenskikh boleznei. 2013; 4: 79–87 (in Russian).
19. Dikke G.B. Polimikrobnye assotsiatsii v etiologii vospalitel'nykh zabolevanii polovykh organov u zhenshchin. Akusherstvo i ginekologiia. 2017; 6: 151–8 (in Russian).
20. WHO guidelines for the treatment of Chlamydia trachomatis. 2016. http://apps.who.int/iris/bitstream/10665/246165/1/9789241549714-eng.pdf.
21. Centers for Disease Control and Prevention. STD Treatment Guidelines. 2015.
22. Pestrikova T.Iu., Voronova Iu.V. Non-specific vaginitis treatment and its efficacy evaluation. Gynecology. 2014; 16 (2): 13–7 (in Russian).
23. Prilepskaya V.N., Mezhevitinova E.A., Khlebkova Iu.S., Zarubina E.N. Vulvovaginitis. Treatment with the use of complex preparations for topical application. Gynecology 2015; 17 (6): 52–5 (in Russian).
24. Pogosian Sh.M., Mezhevitinova E.A., Abakarova P.R. et al. The profile of the expression of the immune response genes in the vagina of women in the complex therapy of recurrent vulvovaginal candidiasis. Gynecology. 2017; 19 (3): 49–54 (in Russian).
Авторы
В.Н. Прилепская*, А.Т. Уруймагова, А.А. Иванова
ФГБУ «Национальный медицинский исследовательский центр акушерства, гинекологии и перинатологии имени академика В.И. Кулакова» Минздрава России, Москва, Россия
*v_prilepskaya@oparina4.ru
________________________________________________
Vera N. Prilepskaya*, Ada T. Uruimagova, Angelina A. Ivanova
Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Moscow, Russia
*v_prilepskaya@oparina4.ru