Фармакотерапия бактериального вагиноза: антибиотики vs антисептики

Abstract

Antimicrobial resistance is one of the public health challenges faced by physicians and scientists all over the globe. According to the antimicrobial resistance prevention strategy adopted in Russia, it is necessary to take measures to ensure rational prescribing and use of antibiotics and, in certain situations, to replace them with medications from other pharmacological groups. In some cases, antiseptics can be a worthy alternative to antibiotics. Dequalinium chloride is an antimicrobial antiseptic agent with a broad bactericidal and fungicidal activity, which allows the treatment of mixed vaginal infections. During intravaginal administration there is no penetration of the drug into the systemic bloodstream, so it is safe for use in clinical practice at any gestational age. The findings support a comparable efficacy of dequalinium chloride and clindamycin against mixed biofilms that are commonly formed on the vaginal mucosa; numerous clinical studies have demonstrated their comparable clinical efficacy in the treatment of bacterial vaginosis. Dequalinium chloride has multiple modes of action against pathogens, which makes the development of resistance to this agent unlikely and thus reduces the risk of resistant strains dominating the microbiome. Wider application of topical antiseptics in the pharmacotherapy for vulvovaginal infections will optimize antibiotic potency, limiting the growth of antimicrobial resistance. Key words: antimicrobial resistance, bacterial vaginosis, antiseptics, dequalinium chloride, pharmacotherapy