According to the sources, vaginal candidiasis develops on the background of papillomavirus infection in 36-41% of cases. The violation of the vaginal bioceno sis decreases the immunological potential of the epithelium, and creates favourable conditions for the carcinogenic effect of the human papillomavirus. We have examined 100 patients (18-40 years old) in order to evaluate the efficiency and safeness of Fluzamed (active ingredient: Fluconazole 150 mg) usage in treatment of vulvovaginal candidiasis with cervical dysplasia caused by papillomavirus infection. The treatment control was performed three times: after the first course of treatment, in 3 and 6 months. The study has shown that due to Fluconazole 150 mg treatment, the disease recurrences at 3 and 6 months were occurred significantly rarely as compared to the cases of Butoconazole 20 mg/g application. The complete eradication of PVI was clinically and laboratory con firmed after 3 and 6 months of treatment. In our study, we have confirmed the safety of a systemic drug Fluzamed (active ingredient: Fluconazole 150 mg) usage by the lack of adverse reactions after its administration.
Pregnancy against the background of bacterial vaginosis is accompanied by a high risk of obstetric and perinatal complications. Therefore, bacterial vaginosis must be treated in pregnant women. Screening and therapy are performed at the beginning of the II or III trimester of pregnancy. The survival of colonies of pathogenic microorganisms in biofilms is significantly increased, so they can remain viable even at high concentrations of antiseptic. The main advantage of using local combined antiseptic agents is the ability to achieve the maximum concentration of the antibiotic exactly in the place of the greatest accumulation of pathogens with the ability to influence biofilms. The objective: was to compare the efficacy and safety of various regimens of therapy with topical combined drugs (Lynda and Meratin Combi) in pregnant women with bacterial vaginosis. Materials and methods. The biocenosis of the vagina was investigated in 351 pregnant women in the II trimester. The diagnosis of bacterial vaginosis was established if the patient had any three of the Amsel criteria. Results. Microbiological screening of the vaginal biocenosis in the II trimester of pregnancy showed that normocenosis among the surveyed was 18.5%; bacterial vaginosis – 31.6%; vulvovaginal candidiasis – 26.5%; aerobic vaginitis – 22.8%, trichomonas vaginitis – 0.6%. Against the background of bacterial vaginosis, the threat of miscarriage, placental dysfunction occurred 6 times more often, anemia and preeclampsia three times more often, gestational pyelonephritis twice more often than in healthy pregnant women. In most patients, the sensitivity of the vaginal microflora to metronidazole and ornidazole is the same, but depends on the dose of the antiseptic, the sensitivity to miconazole was almost twice as high as to nystatin. This confirms the need for a differentiated selection of antiseptics for local therapy of bacterial vaginosis during pregnancy. Conclusion. A more rapid dynamics of the disappearance of the main symptoms of bacterial vaginosis and the normalization of the pH of the vaginal secretion were noted after the use of the drug Limenda. In order to prevent relapse of the disease, it is necessary to carry out the second stage of treatment with probiotics to restore its own lactoflora. Keywords: screening of vaginal biocenosis in the II trimester of pregnancy; complications of pregnancy against the background of bacterial vaginosis; treating bacterial vaginosis during pregnancy; biofilms; sensitivity of the vaginal microflora to antiseptics; topical treatment of bacterial vaginosis; Limenda; Meratin Kombi.
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