Сучасний погляд на цервіковагінальний дисбіоз, викликаний сполученням бактеріальний вагіноз асоційованих бактерій та дріжджоподібних грибів роду Candida (Огляд літератури та власні дані)

Abstract

The article presents modern literature data on the definition and etiopathogenesis of cervicovaginal dysbiosis caused by opportunistic microflora, as well as own data of a comparative study of the effectiveness of treatment of symptomatic cervicovaginal dysbiosis caused by a combination of bacterial vaginosis associated microorganisms and fungi of the genus Candida, using combined drugs containing ternidazole, neomycin, nystatin and prednisolone Na-metasulfobenzoate salt (Terzhinan®) or metronidazole and miconazole. The objective: comparing the effectiveness of treatment of symptomatic cervicovaginal dysbiosis caused by a combination of vaginally associated microorganisms and fungi of the genus Candida, using combined drugs containing ternidazole, neomycin, nystatin and salts of Na-metasulfonobenzoate prednisolone or metoconazole. Materials and methods. The study included 107 women of reproductive age with symptomatic mixed cervicovaginal dysbiosis caused by a combination of bacterial vaginosis associated microorganisms and fungi of the genus Candida, and 30 conditionally gynecologically and somatically healthy control subjects with cervicovaginal eubiosis. Blindly examined women with cervicovaginal dysbiosis were divided into two groups: the main group – 56 patients treated with intravaginal tablets Terzhinan®, the comparison group – 51 women who used vaginal suppositories containing metronidazole and miconazole. The dynamics of clinical data and the state of the cervicovaginal microbiota were evaluated by PCR before the start, one and three months after the end of treatment. Results. An open comparative analysis showed that with topical therapy with Terzhinan® vaginal tablets a month after the end of treatment, a positive clinical effect was observed in 89.29% of women and a microbiological effect in 91.07% of patients, after three months – in 85.71% and in 89.29% of patients, respectively, whereas with topical therapy with vaginal suppositories containing 750 mg of metronidazole and 200 mg of miconazole, respectively, one month after the end of treatment – in 68.73% and 72.55% of cases and after three months – in 62, 75% and 66.67% of cases. Conclusion. Topical monotherapy with Terzhinan® vaginal tablets in comparison with vaginal suppositories containing metronidazole and miconazole demonstrates the clinical and microbiological advantages of Terzhinan® in the treatment of cervicovaginal dysbiosis caused by bacterial vaginosis associated microflora and yeast-like fungi of the genus Candida. Keywords: cervicovaginal microbiota, cervicovaginal dysbiosis, opportunistic microorganisms, bacterial vaginosis associated microorganisms, yeast-like fungi of the genus Candida, Terzhinan®, vaginal suppositories with metronidazole and miconazole, clinical efficacy, microbiological efficacy, safety, long-term results.