What should be considered when choosing a drug for local therapy of nonspecific vaginitis and bacterial vaginosis

Abstract

Vaginal infections are highly spread among the female population and they impact the woman’s organism, fetal development and child health. They remain an important medical and social problem, so the optimizing the treatment is very important. The article is a review of the modern domestic and foreign publications about the etiological factors, pathogenesis, and local pharmacotherapy of nonspecific and candidiasis vaginitis and bacterial vaginosis, including their manifestation during pregnancy. The issues of vaginal infections in non-pregnant and pregnant women, the main risk factors for their development, the range of pathogens of infectious lesions of the vagina, which are the most common - bacterial vaginosis (G. vaginalis and A. vaginae), nonspecific vaginitis (Streptococcus spp., S. aureus, coagulase-negative staphylococci, E. coli, etc.), candidiasis vaginitis (C. albicans and C. non-albicans), and the importance of changes in the composition of the vaginal microbiome in the development of these diseases are demonstrated. Based on the data from scientific publications, the article presents the analysis of the sensitivity of pathogenic flora to anti-infective methods. The attention is drawn to the risks of nonspecific and candidiasis vaginitis and bacterial vaginosis during pregnancy (miscarriage and premature birth, placental insufficiency, etc.), the advantages and disadvantages of systemic and local therapy for these diseases, the comparative characteristics of individual drugs for topical therapy are given, taking into account the composition and pharmacodynamics of their components.The clinical and pharmaceutical benefits of a complex preparation that includes ternidazole, neomycin sulfate, nystatin and prednisolone sodium metasulfobenzoate and has the bactericidal (including antianaerobic), fungicidal, antiprotozoal, and anti-inflammatory effects have been analyzed. Data on the microbiological and clinical efficacy of the drug, its storage effect on the vaginal microbiome, and features of innovative technology for the manufacture of its dosage form are presented.