Opportunities of combination therapy in reproductive age patients with bacterial vaginosis combined with vulvovaginal candidiasis
https://doi.org/10.17749/2313-7347/ob.gyn.rep.2024.572
Abstract
Aim: to assess the effectiveness of combination therapy in reproductive age patients with mixed vaginitis.
Materials and Methods. A retrospective analysis of the therapeutic effectiveness for mixed vaginitis in 158 patients aged 18 to 45 years was carried out. For treatment, the drugs Gainomax (standard dose – thioconazole 100 mg, tinidazole 150 mg in the form of a suppository) and Gainomax plus (standard dose – thioconazole 200 mg, tinidazole 300 mg, lidocaine 100 mg in the form of a suppository) were used for 3 days. The criteria for treatment effectiveness were disappearance of clinical symptoms and normalization of laboratory parameters.
Results. Clinical and laboratory efficacy of therapy reached 95.6 %. Lack of therapeutic effectiveness presented as persistent complaints from patients was recorded in 7 out of 158 (4.4 %) of patients, at the same time, the normalization of vaginal pH was established (pH = 4.1 ± 0.4), the Lactobacilli count increased up to 107 ± 2.8 CFU/cm3, eradication of other opportunistic bacteria and fungi Candida occurred. No side effects were reported while assessing drug safety and tolerability.
Conclusion. Therapy combining thioconazole and tinidazole in treatment of patients with mixed vaginitis demonstrated high effectiveness.
Supporting agencies: The research study was carried out by the authors for the company "Alcea" LLC: a retrospective analysis of patient medical records, text writing and editing. The staff of the medical department of the Alcea company had the opportunity to get acquainted with the results of the current research study, however, all decisions on publication were made personally by the authors of the publication.
About the Authors
I. V. Savelieva
Omsk State Medical University, Health Ministry of Russian Federation
Russian Federation
Russian Federation
Irina V. Savelieva, MD, Dr Sci Med.
Scopus Author ID: 57200599659. WoS ResearcherID: АВА-3474-2021
12 Lenin Str., Omsk 644099
E. A. Bukharova
Omsk State Medical University, Health Ministry of Russian Federation
Russian Federation
Russian Federation
Elena A. Bukharova, MD, PhD.
Scopus Author ID: 57205684835. WoS ResearcherID: ABA-3642-2021
12 Lenin Str., Omsk 644099
E. G. Galyanskaya
Omsk State Medical University, Health Ministry of Russian Federation
Russian Federation
Russian Federation
Elena G. Galyanskaya, MD, PhD.
Scopus Author ID: 57205684257. WoS ResearcherID: АВА-3717-2021
12 Lenin Str., Omsk 644099
N. V. Nosova
Omsk State Medical University, Health Ministry of Russian Federation
Russian Federation
Russian Federation
Natalia V. Nosova, MD.
Scopus Author ID: 57205683143. WoS ResearcherID: ABA-2619-2021
12 Lenin Str., Omsk 644099
P. V. Davydov
Omsk State Medical University, Health Ministry of Russian Federation
Russian Federation
Russian Federation
Pavel V. Davydov, MD.
Scopus Author ID: 57205680365. WoS ResearcherID: ABA-3707-2021
12 Lenin Str., Omsk 644099
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What is already known about this subject?
► Рathological whites remain one of the most common pathologies with which patients turn to gynecologists during outpatient consultations comprising more than 50 % in pattern of all infectious and inflammatory diseases.
► Researchers recognize the existence of microbial combinations as the main predisposing factors in development of mixed vaginitis.
► Currently, mixed vaginitis frequently adopts a recurrent course, which turns into a chronic inflammatory process. The presence of several microorganisms negatively affects the immune system compared to exposure to a single microorganism, which complicates disease diagnostics and treatment.
What are the new findings?
► The clinical and laboratory parameters assessing effectiveness of mixed vaginitis during combination therapy by Gainomax and Gainomax plus reached 95.6 %. Insufficient therapeutic effectiveness was recorded in 7/158 (4.4 %) women, while normalization of vaginal contents pH value reached 4.1 ± 0.4, Lactobacilli count increased up to 107 ± 2.8 CFU/cm3, eradication of opportunistic bacteria and genus Candida fungi occurred.
► Disease-related symptoms completely regressed in 151/158 (95.6 %) of patients, which significantly increases the odds of clinical recovery.
How might it impact on clinical practice in the foreseeable future?
► A drug course according to the instructions for use is associated with a minimal risk of disease resistance and helps to prevent recurrence of the pathological process.
► Positive aspects such as the lack of any-reason drug withdrawal specified in the informed consent evidence about a high patients’ adherence to therapy and allows the drug to be used in treatment of mixed vaginitis beginning from the first day at the outpatient stage.
Review
For citations:
Savelieva I.V., Bukharova E.A., Galyanskaya E.G., Nosova N.V., Davydov P.V. Opportunities of combination therapy in reproductive age patients with bacterial vaginosis combined with vulvovaginal candidiasis. Obstetrics, Gynecology and Reproduction. 2024;18(6):800-808. (In Russ.) https://doi.org/10.17749/2313-7347/ob.gyn.rep.2024.572
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