medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/ms2026-141medsovet-10091Research ArticleУРОЛОГИЯ / НЕФРОЛОГИЯ / ВНУТРЕННИЕ БОЛЕЗНИUROLOGY / NEPHROLOGY / INTERNAL DISEASESВозможности современной антибактериальной терапии у пациентов с уретритами на фоне инфекций, передаваемых половым путемPotential of current antibacterial therapy in patients with urethritis due to sexually transmitted diseaseshttps://orcid.org/0000-0003-4897-3875ХазанП. Л.KhazanP. L.

Хазан Петр Леонидович, к.м.н., старший научный сотрудник, врач-уролог, врач – клинический фармаколог

105425, Москва, ул. 3-я Парковая, д. 51, стр. 4

Petr L. Khazan, Cand. Sci. (Med.), Senior Researcher, Urologist, Clinical Pharmacologist

51, Bldg. 4, 3rd Parkovaya St., Moscow, 105425

p_hasan2000@mail.ruhttps://orcid.org/0009-0001-6747-7677МнацаканьянА. Н.MnatsakanyanA. N.

Мнацаканьян Анна Никитична, к.фил.н., доцент кафедры Л-2

105005, Москва, ул. 2-я Бауманская, д. 5

Anna N. Mnatsakanyan, Cand. Sci. (Philol.), Associate Professor of the Department L-2

5, 2nd Baumanskaya St., Moscow, 105005

man@bmstu.ruhttps://orcid.org/0000-0002-3367-9844БлиновД. В.BlinovD. V.

Блинов Дмитрий Владиславович, д.м.н., руководитель по медицинским и научным вопросам, Институт превентивной и социальной медицины; доцент кафедры спортивной, физической и реабилитационной медицины, Московский медико-социальный институт имени Ф.П. Гааза; научный сотрудник лаборатории научных исследований, Федеральный научно-клинический центр медицинской реабилитации и курортологии Федерального медико-биологического агентства

101000, Москва, Лялин пер., д. 11–13/1,

123056 Москва, 2-я Брестская ул., д. 5, стр. 1–1а,

141551, Московская обл., г. о. Солнечногорск, п. г. т. Голубое, ул. Родниковая, стр. 6, корп. 1

Dmitry V. Blinov, Dr. Sci. (Med.), Head of Medical and Scientific Affairs, Institute of Preventive and Social Medicine; Associate Professor of the Department of Sports, Physical and Rehabilitation Medicine, Moscow Medical and Social Institute named after F.P. Haaz; Researcher of the Laboratory of Scientific Research, Federal Scientific and Clinical Center for Medical Rehabilitation and Balneology of the Federal Medical-Biological Agency

11–13/1, Lyalin Lane, Moscow, 101000,

5, Bldg 1–1a, 2nd Brestskaya St., Moscow 123056,

Bldg. 6, Block 1, Rodnikovaya St., Urban-type Settlement Goluboe, Solnechnogorsk Urban District, Moscow Region, 141551

blinov2010@googlemail.comНаучно-исследовательский институт урологии и интервенционной радиологии имени Н.А. Лопаткина – филиал Национального медицинского исследовательского центра радиологииРоссияLopatkin Research Institute of Urology and Interventional Radiology – Branch of the National Medical Research Radiological CenterRussian FederationМосковский государственный технический университет имени Н.Э. БауманаРоссияBauman Moscow State Technical UniversityRussian FederationИнститут превентивной и социальной медицины; Московский медико-социальный институт имени Ф.П. Гааза; Федеральный научно-клинический центр медицинской реабилитации и курортологии Федерального медико-биологического агентстваРоссияInstitute of Preventive and Social Medicine; Moscow Medical and Social Institute named after F.P. Haaz; Federal Scientific and Clinical Center for Medical Rehabilitation and Balneology of the Federal Medical-Biological AgencyRussian Federation202631052026205148157Copyright © Хазан П.Л., Мнацаканьян А.Н., Блинов Д.В., 20262026Хазан П.Л., Мнацаканьян А.Н., Блинов Д.В.Khazan P.L., Mnatsakanyan A.N., Blinov D.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/10091

Уретрит относится к числу наиболее распространенных урологических заболеваний у мужчин. Ежегодно в Российской Федерации регистрируется около 350 тыс. случаев негонококкового уретрита, что составляет до 65% всех воспалительных заболеваний мочеполового тракта. В последние годы мировое медицинское сообщество столкнулось с серьезным вызовом в виде значительного роста антибиотикорезистентности среди микроорганизмов, возбудителей негонококкового уретрита. Особую озабоченность вызывает формирование устойчивости у внутриклеточных патогенов. Данный феномен существенно ограничивает эффективность стандартных схем эмпирической терапии и диктует необходимость поиска и клинического внедрения альтернативных антибактериальных подходов. В обзоре обобщены данные о современных подходах к антибактериальной терапии уретритов. Использованы рецензируемые источники из баз данных PubMed/MEDLINE, eLIBRARY.RU, Cochrane Library, Google Scholar, а также отечественные и зарубежные клинические рекомендации и руководства. Всего включено 79 источников, в том числе обзорные статьи и оригинальные исследования. Ввиду гетерогенности результатов обзор носит описательный (нарративный) характер. Также приведен клинический случай – собственное наблюдение авторов из реальной клинической практики, демонстрирующее возможности современной антибактериальной терапии у пациента с микст-инфекцией, сочетанной с органической патологией, развившейся вследствие гонококкового уретрита. Джозамицин сохраняет активность при росте макролидной резистентности. Препарат имеет минимальные побочные эффекты и разрешен к применению у беременных и детей. В связи с этим джозамицин рассматривается как эффективная и безопасная альтернатива при урогенитальных инфекциях, особенно в условиях полирезистентности. В контексте вышеуказанных проблем джозамицин сохраняет свои позиции как один из немногих макролидных антибиотиков, демонстрирующих высокую активность в отношении ключевых урогенитальных патогенов: Mycoplasma genitalium, Chlamydia trachomatis, Ureaplasma urealyticum и Mycoplasma hominis.

Urethritis is among the most common urological diseases in men. In the Russian Federation, approximately 350,000 cases of non-gonococcal urethritis are reported each year, which accounts for up to 65% of all inflammatory diseases of the genitourinary (GU) system. In recent years, the global medical community has faced a serious challenge of significantly increased spreading of antibiotic resistance among these microorganisms. The mechanisms acquired by intracellular pathogens to counteract the effect of antibiotics is of particular concern. This phenomenon significantly limits the effectiveness of standard empirical treatment regimens and urges healthcare professionals to discover and clinically implement alternative antibacterial approaches. This review summarizes data on current approaches to antibacterial therapy for urethritis. The authors used peer-reviewed sources from PubMed/MEDLINE, eLIBRARY.RU, Cochrane Library, and Google Scholar, as well as national and international clinical guidelines and recommendations. In total, 79 sources (review articles and original studies among the number) were included. As the results are heterogeneous, the authors used descriptive (narrative) synthesis in the review. A clinical case included as an authors' own observation from real-world clinical practice demonstrates the potential of current antibacterial therapy in a patient with a mixed infection and concomitant organic pathology resulted from gonococcal urethritis. Josamycin maintains activity with the growth of macrolide resistance. The drug has minimal side effects and is approved for use in pregnant women and children. For this reason, Josamycin is considered an effective and safe alternative in urogenital infections, particularly in the presence of multidrug-resistant bacteria. In the context of the above-mentioned issues, Josamycin retains its position as one of the few macrolide antibiotics demonstrating high activity against key urogenital pathogens, such as Mycoplasma genitalium, Chlamydia trachomatis, Ureaplasma urealyticum, and Mycoplasma hominis.

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The authors declare that there are no conflicts of interest present.