Лечение и профилактика рецидивирующих вульвовагинальных инфекций у пациенток с воспалительными заболеваниями органов малого таза

Abstract

Objective. To study the influence of vaginal microbiocoenosis on the clinical course of pelvic inflammatory disease (PID) and evaluate the efficacy of the long-term use of probiotic Gynoflor E in case of recurrent vulvovaginal infections in patients of this group. Patients and methods. 117 patients diagnosed with «pelvic inflammatory disease, acute vulvovaginitis» were examined. Patients were divided into two groups: the main group consisted of 45 patients for whom Gynoflor E was prescribed (1 tablet per day for 6 days in the first phase of two subsequent menstrual cycles) in outpatient conditions after treatment of vulvovaginitis (Fluomizin intravaginally (1 tablet per day for 6 days) + Gynoflor E (intravaginally for 6 days); the comparison group included 28 women who received two-stage treatment: an antiseptic was prescribed (Fluomizin intravaginally, 1 tablet per day for 6 days), then Gynoflor E for 6 days (vaginal tablets containing eubiotic + estrogen). Evaluation of the effectiveness was carried out after the end of the treatment course in 3 and 6 months. Results. The effectiveness of two-stage treatment of vulvovaginitis with the inclusion of antiseptic and Gynoflor E in the complex of treatment was 94.5%. The long-term prescription of the drug Gynoflor E contributed to the maintenance of physiological vaginal microbiocoenosis after 6-month treatment in 82.0% of patients (in the comparison group – 46.4%) and reduced recurrence nearly twice. Conclusion. The study showed a high (89.7%) commitment to long-term treatment, however, it should be noted that these are not population indicators, but the group of patients with chronic PID and recurrent vaginal infections. Key words: antiseptic, pelvic inflammatory disease, vulvovaginitis, Gynoflor E, long-term microbiocoenosis correction scheme, recurrence, chronic course