Обґрунтування сучасних принципів лікування бактеріальних вагінозів у жінок (Огляд літератури)

Abstract

Bacterial vaginosis occupies a special place among infectious-inflammatory diseases of the female sexual system. The increase in the frequency of these diseases is due to a number of factors whose effects can be reduced or eliminated altogether. The proportion of bacterial vaginosis among vulvovaginal infections depends on ethnic characteristics, environmental factors, as well as the number of women. Bacterial vaginosis acts as a risk factor for complications during pregnancy, in childbirth and in the postnatal period. Relapses of the disease develop in every second woman regardless of the treatment regimen. Meta-analysis has shown that the development of bacterial vaginosis can be associated with more than 200 species of microorganisms. In women with bacterial vaginosis, there is an increase of 1.5 times the relative risk of infection with human papilloma virus, and therefore the development of cervical neoplasia. In many countries of the world, the increase in inflammatory diseases is a result of population migration, urbanization, changes in sexual behaviour, deterioration of the environmental situation, etc. It is known that microorganisms in biofilms become practically inaccessible to immune protection factors, so the survival of colonies in biofilms is significantly increased. Standard approaches based on the principles of evidence-based medicine should be used to diagnose and treat bacterial vaginosis. International recommendations for the treatment of bacterial vaginosis include therapy aimed at eliminating the agent, alleviating symptoms of the disease, increasing local and general immunities and normalizing biocinosis. In general, treatment patterns according to the recommendations of different medical societies are similar. Treatment of asymptomatic forms of bacterial vaginosis in pregnant women reduces the incidence of complications of pregnancy, childbirth and the postpartum period. For the treatment of patients with insufficient motivation, it is desirable to give preference to schemes that have proven their distant anti-clinical effectiveness. Two-stage therapy of bacterial vaginosis using modern local combination antiseptic drug of wide spectrum action Limendа and with mandatory restoration of vaginal microflora with the preparation Вreveluck are effective in treatment of bacterial vaginosis and reduce risk of relapses. Key words: bacterial vaginosis, Limenda, Вreveluck.