medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/2079-701X-2019-7-93-103medsovet-2936Research ArticleИНФЕКЦИИINFECTIONSБактериальный вагиноз: есть ли альтернатива традиционным препаратам?Bacterial Vaginosis: Is there an alternative to traditional drugs?МаловаИ. О.MalovaI. O.

Малова Ирина Олеговна – д.м.н., профессор кафедры дерматовенероло- гии и косметологии.

664003, Россия, г. Иркутск, ул. Красного Восстания, д. 1.

Malova Irina Olegovna – Dr of Sci. (Med), Professor.

664003, Russia, Irkutsk, 1, Krasnogo Vosstaniya St..

marinakartina@mail.ruАфанасьеваИ. Г.AfanasyevaI. G.

Афанасьева Ирина Геннадьевна – к.м.н., ассистент кафедры дерматовенерологии и косметологии.

664003, Россия, г. Иркутск, ул. Красного Восстания, д. 1.

Afanasyeva Irina Gennadyevna – Candidate of Medical Sciences, Assistant.

664003, Russia, Irkutsk, 1, Krasnogo Vosstaniya St..

Irishaf@yandex.ruФедеральное государственное бюджетное образовательное учреждение высшего образования «Иркутский государственный медицинский университет» Министерства здравоохранения Российской Федерации.РоссияFederal State Budgetary Educational Institution of Higher Education «Irkutsk State Medical University» of the Ministry of Health of the Russian Federation.Russian Federation2019050420190793103Copyright © Малова И.О., Афанасьева И.Г., 20192019Малова И.О., Афанасьева И.Г.Malova I.O., Afanasyeva I.G.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/2936

Обсуждаются результаты терапии 204 пациенток с бактериальным вагинозом метронидазолом, клиндамицином и деквалиния хлоридом, а также эффективность двухэтапного лечения с последовательным применением этиотропного препарата и препарата лактобактерий.

The results of treatment of 204 patients with bacterial vaginosis with metronidazole, clindamycin and dequalinium chloride, as well as the efficacy of two-stage treatment with consistent use of etiotropic drug and lactobacillus drug are discussed.

бактериальный вагинозLactobacillus acidophilusAtopobium vaginaeGardnerella vaginalisдеквалиния хлоридметронидазолклиндамицинэстриолbacterial vaginosisLactobacillus acidophilusAtopobium vaginaeGardnerella vaginalisdequalinium chloridemetronidazoleclindamycinestriolReferencesTurovskiy Y., Sutyak Noll K., Chikindas M.L. The aetiology of bacterial vaginosis. J. Appl. Microbiol. 2011;110:1105–1128.Turovskiy Y., Sutyak Noll K., Chikindas M.L. The aetiology of bacterial vaginosis. J. Appl. Microbiol. 2011;110:1105–1128.Bautista C.T., Wurapa E., Sateren W.B., Morris S., Hollingsworth B., Sanchez J.L. Bacterial vaginosis: a synthesis of the literature on etiology, prevalence, risk factors, and relationship with chlamydia and gonorrhea infections. Mil Med Res. 2016;13:3-4.Bautista C.T., Wurapa E., Sateren W.B., Morris S., Hollingsworth B., Sanchez J.L. Bacterial vaginosis: a synthesis of the literature on etiology, prevalence, risk factors, and relationship with chlamydia and gonorrhea infections. Mil Med Res. 2016;13:3-4.Bradshaw C.S., Brotman R.M. Making inroads into improving treatment of bacterial vaginosis – striving for long-term cure. BMC Infect Dis. 2015;15:292.Bradshaw C.S., Brotman R.M. Making inroads into improving treatment of bacterial vaginosis – striving for long-term cure. BMC Infect Dis. 2015;15:292.Кулаков В.И., Савельева Г.М., Манухин И.Б. Гинекология. Национальное руководство. М.: ГЭОТАР Медиа, 2011, 1072 с. [Kulakov V.I., Savelieva G.M., Manukhin I.B. Gynecology. National manual. M.: GEOTHARMedia, 2011, 1072 p.] (In Russ.)Кулаков В.И., Савельева Г.М., Манухин И.Б. Гинекология. Национальное руководство. М.: ГЭОТАР Медиа, 2011, 1072 с. [Kulakov V.I., Savelieva G.M., Manukhin I.B. Gynecology. National manual. M.: GEOTHARMedia, 2011, 1072 p.] (In Russ.)Диагностика и лечение заболеваний, сопровождающихся патологическими выделениями из половых путей женщин. Клинические рекомендации под ред. В.Н. Прилепской и соавт. М., 2013, 50 с. [Diagnostics and treatment of diseases accompanied by pathological discharges from the genital tract of women. Clinical recommendations edited by V.N. Prilepskaya et al., 2013, 50 p.] (In Russ.)Диагностика и лечение заболеваний, сопровождающихся патологическими выделениями из половых путей женщин. Клинические рекомендации под ред. В.Н. Прилепской и соавт. М., 2013, 50 с. [Diagnostics and treatment of diseases accompanied by pathological discharges from the genital tract of women. Clinical recommendations edited by V.N. Prilepskaya et al., 2013, 50 p.] (In Russ.)Ishaque S., Yakoob M.Y., Imdad A., Goldenberg R.L., Eisele T.P., Bhutta Z.A. Effectiveness of interventions to screen and manage infections during pregnancy on reducing stillbirths: A review. BMC Public Health. 2011, 11 с.Ishaque S., Yakoob M.Y., Imdad A., Goldenberg R.L., Eisele T.P., Bhutta Z.A. Effectiveness of interventions to screen and manage infections during pregnancy on reducing stillbirths: A review. BMC Public Health. 2011, 11 с.Briery C.M., Chauhan S.P., Magann E.F., Cushman J.L., Morrison J.C. Treatment of bacterial vaginosis does not reduce preterm birth among high-risk asymptomatic women in fetal fibronectin positive patients. J. Miss. State Med. Assoc. 2011;52:72–75.Briery C.M., Chauhan S.P., Magann E.F., Cushman J.L., Morrison J.C. Treatment of bacterial vaginosis does not reduce preterm birth among high-risk asymptomatic women in fetal fibronectin positive patients. J. Miss. State Med. Assoc. 2011;52:72–75.Lamont R.F., Sobel J.D., Akins R.A., Hassan S.S., Chaiworapongsa T., Kusanovic J.P. et al. The vaginal microbiome: New information about genital tract flora using molecular based techniques. BJOG. 2011;118:533–549.Lamont R.F., Sobel J.D., Akins R.A., Hassan S.S., Chaiworapongsa T., Kusanovic J.P. et al. The vaginal microbiome: New information about genital tract flora using molecular based techniques. BJOG. 2011;118:533–549.Menon R., Dunlop A.L., Kramer M.R., Fortunato S.J., Hogue C.J. An overview of racial disparities in preterm birth rates: Caused by infection or inflammatory response? Acta Obstet. Gynecol. Scand. 2011;90:1325–1331.Menon R., Dunlop A.L., Kramer M.R., Fortunato S.J., Hogue C.J. An overview of racial disparities in preterm birth rates: Caused by infection or inflammatory response? Acta Obstet. Gynecol. Scand. 2011;90:1325–1331.Hillier S. The complexity of microbial diversity in bacterial vaginosis. N Eng J Med. 2005;353:1886–1887.Hillier S. The complexity of microbial diversity in bacterial vaginosis. N Eng J Med. 2005;353:1886–1887.Bilardi J.E., Walker S., Temple-Smith M., McNair R., Mooney-Somers J., Bellhouse C. The Burden of Bacterial Vaginosis: Women’s Experience of the Physical, Emotional, Sexual and Social Impact of Living with Recurrent Bacterial Vaginosis. PLoS One. 2013;8(9):74-78.Bilardi J.E., Walker S., Temple-Smith M., McNair R., Mooney-Somers J., Bellhouse C. The Burden of Bacterial Vaginosis: Women’s Experience of the Physical, Emotional, Sexual and Social Impact of Living with Recurrent Bacterial Vaginosis. PLoS One. 2013;8(9):74-78.Ibrahim S.M., Bukar M., Galadima G.B., Audu B.M., Ibrahim H.A. Prevalence of bacterial vaginosis in pregnant women in Maiduguri, North-Eastern Nigeria. Niger J Clin Pract. 2014;17(2):154-8.Ibrahim S.M., Bukar M., Galadima G.B., Audu B.M., Ibrahim H.A. Prevalence of bacterial vaginosis in pregnant women in Maiduguri, North-Eastern Nigeria. Niger J Clin Pract. 2014;17(2):154-8.Alcaide M.L., Chisembele M., Malupande E., Arheart K., Fischl M., Jones D.L. A cross-sectional study of bacterial vaginosis, intravaginal practices and HIV genital shedding; implications for HIV transmission and women’s health. BMJ Open. 2015;5:e009036.Alcaide M.L., Chisembele M., Malupande E., Arheart K., Fischl M., Jones D.L. A cross-sectional study of bacterial vaginosis, intravaginal practices and HIV genital shedding; implications for HIV transmission and women’s health. BMJ Open. 2015;5:e009036.Lallar M., Nanda S., Nandal R.J. Lower Genital Tract Infections in HIV-Infected Women: Can We Afford to Miss? Obstet Gynaecol India. 2015;65(1):45-9.Lallar M., Nanda S., Nandal R.J. Lower Genital Tract Infections in HIV-Infected Women: Can We Afford to Miss? Obstet Gynaecol India. 2015;65(1):45-9.Ghiasi M., Fazaeli H., Kalhor N., Sheykh-Hasan M., Tabatabaei-Qomi R. Assessing the prevalence of bacterial vaginosis among infertile women of Qom city. Iran J Microbiol. 2014; 6(6):404-408.Ghiasi M., Fazaeli H., Kalhor N., Sheykh-Hasan M., Tabatabaei-Qomi R. Assessing the prevalence of bacterial vaginosis among infertile women of Qom city. Iran J Microbiol. 2014; 6(6):404-408.Guédou F.A., Van Damme L., Deese J., Crucitti T., Becker M., Mirembe F. et al. Behavioural and medical predictors of bacterial vaginosis recurrence among female sex workers: longitudinal analysis from a randomized controlled trial. BMC Infect Dis. 2013;13:208.Guédou F.A., Van Damme L., Deese J., Crucitti T., Becker M., Mirembe F. et al. Behavioural and medical predictors of bacterial vaginosis recurrence among female sex workers: longitudinal analysis from a randomized controlled trial. BMC Infect Dis. 2013;13:208.Vodstrcil L.A., Walker S.M., Hocking J.S., Law M., Forcey D.S., Fehler G., et al. Incident bacterial vaginosis (BV) in women who have sex with women is associated with behaviors that suggest sexual transmission of BV. Clin Infect Dis. 2015; 60(7):1042-1053.Vodstrcil L.A., Walker S.M., Hocking J.S., Law M., Forcey D.S., Fehler G., et al. Incident bacterial vaginosis (BV) in women who have sex with women is associated with behaviors that suggest sexual transmission of BV. Clin Infect Dis. 2015; 60(7):1042-1053.Bradshaw C.S., Walker S.M., Vodstrcil L.A., Bilardi J.E., Law M., Hocking J.S. et al. The influence of behaviors and relationships on the vaginal microbiota of women and their female partners: The WOW health study. J. Infect. Dis. 2014;209:1562–1572.Bradshaw C.S., Walker S.M., Vodstrcil L.A., Bilardi J.E., Law M., Hocking J.S. et al. The influence of behaviors and relationships on the vaginal microbiota of women and their female partners: The WOW health study. J. Infect. Dis. 2014;209:1562–1572.Marrazzo J.M., Antonio M., Agnew K., Hillier S.L. Distribution of genital Lactobacillus strains shared by female sex partners. J. Infect. Dis. 2009;199:680–683.Marrazzo J.M., Antonio M., Agnew K., Hillier S.L. Distribution of genital Lactobacillus strains shared by female sex partners. J. Infect. Dis. 2009;199:680–683.Verstraelen H., Swidsinski A. The biofilm in bacterial vaginosis: implications for epidemiology, diagnosis and treatment. Current Opinion in Infectious Diseases. 2013;26(1):86–89.Verstraelen H., Swidsinski A. The biofilm in bacterial vaginosis: implications for epidemiology, diagnosis and treatment. Current Opinion in Infectious Diseases. 2013;26(1):86–89.Schwebke J.R., Muzny C.A., Josey W.E. Role of Gardnerella vaginalis in the pathogenesis of bacterial vaginosis: a conceptual model. J Infect Dis. 2014;210(3):338-43.Schwebke J.R., Muzny C.A., Josey W.E. Role of Gardnerella vaginalis in the pathogenesis of bacterial vaginosis: a conceptual model. J Infect Dis. 2014;210(3):338-43.Witkin S.S., Ledger W.J. Complexities of the uniquely human vagina. Sci Transl Med. 2012;4:132fs11.Witkin S.S., Ledger W.J. Complexities of the uniquely human vagina. Sci Transl Med. 2012;4:132fs11.Рахматулина М.Р.Опыт применения 5-нитро-имидазолов в терапии бактериального вагиноза. Российский вестник акушера-гинеколога. 2015;6:92-97. [Rakhmatulina M.R. Experience of using 5-nitroimidazoles in therapy of bacterial vaginosis. Russian Bulletin of Obstetrician-Gynaecologist [Rossijskij vestnik akushera-ginekologa.].2015;6:92-97.](In Russ.)Рахматулина М.Р.Опыт применения 5-нитро-имидазолов в терапии бактериального вагиноза. Российский вестник акушера-гинеколога. 2015;6:92-97. [Rakhmatulina M.R. Experience of using 5-nitroimidazoles in therapy of bacterial vaginosis. Russian Bulletin of Obstetrician-Gynaecologist [Rossijskij vestnik akushera-ginekologa.].2015;6:92-97.](In Russ.)Рахматулина М.Р. Диагностические и терапевтические аспекты ведения пациенток с бактериальным вагинозом. Гинекология. 2012;14(4):27-32. [Rakhmatulina M.R. Diagnostic and therapeutic aspects of management of patients with bacterial vaginosis. Gynecology [Ginekologiya.].2012;14(4):27-32.](In Russ.)Рахматулина М.Р. Диагностические и терапевтические аспекты ведения пациенток с бактериальным вагинозом. Гинекология. 2012;14(4):27-32. [Rakhmatulina M.R. Diagnostic and therapeutic aspects of management of patients with bacterial vaginosis. Gynecology [Ginekologiya.].2012;14(4):27-32.](In Russ.)Рахматулина М.Р., Плахова К.И. Бактериальный вагиноз, ассоциированный с Atopobiumvaginae. Акушерство и гинекология. 2012;3:88-92. [Rakhmatulina M.R., Plakhova K.I. Bacterial vaginosis associated with Atopobium vaginae. Obstetrics and gynecology [Akusherstvo i ginekologiya.]. 2012;3:88-92.] (In Russ.)Рахматулина М.Р., Плахова К.И. Бактериальный вагиноз, ассоциированный с Atopobiumvaginae. Акушерство и гинекология. 2012;3:88-92. [Rakhmatulina M.R., Plakhova K.I. Bacterial vaginosis associated with Atopobium vaginae. Obstetrics and gynecology [Akusherstvo i ginekologiya.]. 2012;3:88-92.] (In Russ.)Sexually Transmitted Diseases Treatment Guidelines, Recommendations and Reports June 5, 2015/64(RR3); CDC. 1-137. https://www.cdc.gov/Mmwr/preview/mmwrhtml/rr6403a1.htm.Sexually Transmitted Diseases Treatment Guidelines, Recommendations and Reports June 5, 2015/64(RR3); CDC. 1-137. https://www.cdc.gov/Mmwr/preview/mmwrhtml/rr6403a1.htm.Tiplica G.-S., Radcliffe K., Evans C., Gomberg M., Nandwani R., Rafila A., Nedelcu L., Salavastru C. GUIDELINES 2015 European guidelines for the management of partners of persons with sexually transmitted infections. doi: 10.1111/jdv.13181 https://www.iusti.org/regions/Europe/pdf/2015/PartnerNotificationEADV.pdf.Tiplica G.-S., Radcliffe K., Evans C., Gomberg M., Nandwani R., Rafila A., Nedelcu L., Salavastru C. GUIDELINES 2015 European guidelines for the management of partners of persons with sexually transmitted infections. doi: 10.1111/jdv.13181 https://www.iusti.org/regions/Europe/pdf/2015/PartnerNotificationEADV.pdf.Федеральные клинические рекомендации. Дерматовенерология 2015: Болезни кожи. Инфекции, передаваемые половым путем. Деловой экспресс. 2016:645–654. [Federal clinical guidelines. Dermatovenerology 2015: Skin diseases. Sexually-transmitted infections. Business Express [Delovoj ekspress].2016:645–654.] (In Russ.)Федеральные клинические рекомендации. Дерматовенерология 2015: Болезни кожи. Инфекции, передаваемые половым путем. Деловой экспресс. 2016:645–654. [Federal clinical guidelines. Dermatovenerology 2015: Skin diseases. Sexually-transmitted infections. Business Express [Delovoj ekspress].2016:645–654.] (In Russ.)Sexually Transmitted Diseases Treatment Guidelines, Recommendations and Reports June 5, 2015/64(RR3);1-137 2015 – CDC https:/www.cdc.gov/Mmwr/preview/mmwrhtml/rr6403a1.htm.Sexually Transmitted Diseases Treatment Guidelines, Recommendations and Reports June 5, 2015/64(RR3);1-137 2015 – CDC https:/www.cdc.gov/Mmwr/preview/mmwrhtml/rr6403a1.htm.Brandt M., Abels S., May T. et al. Intravaginally applied metronidasole is as effective as orally applied in the treatment of bacterial vaginosis, but exhibits significantly less side effects. Europ. J. Obstet. Gynecol. Reprod. Biol. 2008;141:158-162.Brandt M., Abels S., May T. et al. Intravaginally applied metronidasole is as effective as orally applied in the treatment of bacterial vaginosis, but exhibits significantly less side effects. Europ. J. Obstet. Gynecol. Reprod. Biol. 2008;141:158-162.Donders G.G., Zodzika J., Rezeberga D. Treatment of bacterial vaginosis: what we have and what we miss. Expert Opin Pharmacother.2014;15(5):645-57.Donders G.G., Zodzika J., Rezeberga D. Treatment of bacterial vaginosis: what we have and what we miss. Expert Opin Pharmacother.2014;15(5):645-57.Lopes dos Santos Santiago G., Grob P., Verstraelen H., Waser F., Vaneechoutte M. Susceptibility testing of Atopobium vaginae for dequalinium chloride. BMC Res Notes.2012;19(5):151.Lopes dos Santos Santiago G., Grob P., Verstraelen H., Waser F., Vaneechoutte M. Susceptibility testing of Atopobium vaginae for dequalinium chloride. BMC Res Notes.2012;19(5):151.Weissenbacher E.R., Donders G., Unzeitig V., Martinez de Tejada B., Gerber S., Halaška M. et al. A Comparison of Dequalinium Chloride Vaginal Tablets (Fluomizin®) and Clindamycin Vaginal Cream in Treatment of Bacterial Vaginosis : a single-blind, randomized clinical trial of efficacy and safety. Gynecol Obstet Invest.2012;73(1):8-15.Weissenbacher E.R., Donders G., Unzeitig V., Martinez de Tejada B., Gerber S., Halaška M. et al. A Comparison of Dequalinium Chloride Vaginal Tablets (Fluomizin®) and Clindamycin Vaginal Cream in Treatment of Bacterial Vaginosis : a single-blind, randomized clinical trial of efficacy and safety. Gynecol Obstet Invest.2012;73(1):8-15.Подзолкова Н.М., Никитина Т.И. Сравни-тельная оценка различных схем лечения больных с бактериальным вагинозом и не-специфическим вульвовагинитом. Российский вестник акушера-гинеколога. 2012;12(5):72-80. [Podzolkova N.M., Nikitina T.I. Comparative assessment of different treatment schemes for patients with bacterial vaginosis and nonspecific vulvovaginitis. Russian Bulletin of Obstetrician-Gynaecologist [Rossijskij vestnik akusheraginekologa.]. 2012;12(5):72-80.] (In Russ.)Подзолкова Н.М., Никитина Т.И. Сравни-тельная оценка различных схем лечения больных с бактериальным вагинозом и не-специфическим вульвовагинитом. Российский вестник акушера-гинеколога. 2012;12(5):72-80. [Podzolkova N.M., Nikitina T.I. Comparative assessment of different treatment schemes for patients with bacterial vaginosis and nonspecific vulvovaginitis. Russian Bulletin of Obstetrician-Gynaecologist [Rossijskij vestnik akusheraginekologa.]. 2012;12(5):72-80.] (In Russ.)Verstraelen H., Verhelst R. Bacterial vaginosis: an update on diagnosis andtreatment. Expert Rev Anti Infect Ther. 2009;7:1109-1124.Verstraelen H., Verhelst R. Bacterial vaginosis: an update on diagnosis andtreatment. Expert Rev Anti Infect Ther. 2009;7:1109-1124.Ефимов Б.А., Тютюнник В.Л., Бактериальный вагиноз: современный взгляд на проблему. РМЖ. 2008;16(1):18–22. [Efimov B.A., Tyutyunnik V.L., Bacterial Vaginosis: A Modern View of the Problem. RMJ.2008;16(1):18–22.] (In Russ.)Ефимов Б.А., Тютюнник В.Л., Бактериальный вагиноз: современный взгляд на проблему. РМЖ. 2008;16(1):18–22. [Efimov B.A., Tyutyunnik V.L., Bacterial Vaginosis: A Modern View of the Problem. RMJ.2008;16(1):18–22.] (In Russ.)Радзинский В.Е., Хамошина М.Б., Календжян А.С. Эффективная коррекция нарушений биоценоза влагалища вне и во время беременности: почему это важно и что нового? Доктор.Ру. (Гинекология). 2010;7(58, 1):20–26. [Radzinsky V.E., Hamoshina M.B., Kalenjyan A.S. Effective correction of vaginal biocenosis disorders in the nonpregnant state and during pregnancy: why is it important and what is new? Doctor.Ru. (Gynecology) [Doktor.Ru. (Ginekologiya).].2010;7(58, 1):20–26.] (In Russ.)Радзинский В.Е., Хамошина М.Б., Календжян А.С. Эффективная коррекция нарушений биоценоза влагалища вне и во время беременности: почему это важно и что нового? Доктор.Ру. (Гинекология). 2010;7(58, 1):20–26. [Radzinsky V.E., Hamoshina M.B., Kalenjyan A.S. Effective correction of vaginal biocenosis disorders in the nonpregnant state and during pregnancy: why is it important and what is new? Doctor.Ru. (Gynecology) [Doktor.Ru. (Ginekologiya).].2010;7(58, 1):20–26.] (In Russ.)Mastromarino P., Macchia S., Meggiorini L., Trinchieri V., Mosca L., Perluigi M.et al. Effectiveness of Lactobacillus-containing vaginal tablets in the treatment of symptomatic bacterial vaginosis. Clin Microbiol Infect. 2009;15:67-74.Mastromarino P., Macchia S., Meggiorini L., Trinchieri V., Mosca L., Perluigi M.et al. Effectiveness of Lactobacillus-containing vaginal tablets in the treatment of symptomatic bacterial vaginosis. Clin Microbiol Infect. 2009;15:67-74.Кира Е.Ф., Пекарев О.Г., Молчанов О.Г., Мальцева Л.И., Аксененко В.А., Селихова М.С. и др. Сравнительный анализ эффективности и безопасности параллельного или последовательного сочетания метронидазола с молочной кислотой и двухэтапного метода метронидазол плюс пробиотик. Многоцентровое рандомизированное контролируемое исследование. Акушерство и гинекология. 2016;9:87-93. [Kira E.F., Pekarev O.G., Molchanov O.G., Maltseva L.I., Aksenenko V.A., Selikhova M.S. et al. Comparative analysis of effectiveness and safety of parallel or sequential combination of metronidazole with lactic acid and two-stage method of metronidazole plus probiotic. Multicenter randomized controlled trial. Obstetrics and gynecology [Akusherstvo i ginekologiya].2016;9:87-93.] (In Russ.)Кира Е.Ф., Пекарев О.Г., Молчанов О.Г., Мальцева Л.И., Аксененко В.А., Селихова М.С. и др. Сравнительный анализ эффективности и безопасности параллельного или последовательного сочетания метронидазола с молочной кислотой и двухэтапного метода метронидазол плюс пробиотик. Многоцентровое рандомизированное контролируемое исследование. Акушерство и гинекология. 2016;9:87-93. [Kira E.F., Pekarev O.G., Molchanov O.G., Maltseva L.I., Aksenenko V.A., Selikhova M.S. et al. Comparative analysis of effectiveness and safety of parallel or sequential combination of metronidazole with lactic acid and two-stage method of metronidazole plus probiotic. Multicenter randomized controlled trial. Obstetrics and gynecology [Akusherstvo i ginekologiya].2016;9:87-93.] (In Russ.)https://www.who.int/mediacentre/factsheets/antibiotic-resistance/ru/.https://www.who.int/mediacentre/factsheets/antibiotic-resistance/ru/.Dover S.E., Aroutcheva A.A., Faro S., Chikindas M.L. Natural antimicrobials and their role in vaginal health: A short review. Int J Probiotics Prebiotics. 2008;3:219–230.Dover S.E., Aroutcheva A.A., Faro S., Chikindas M.L. Natural antimicrobials and their role in vaginal health: A short review. Int J Probiotics Prebiotics. 2008;3:219–230.Радзинский В.Е., Ордиянц И.М., Четвертакова Э.С., Мисуно О.А. Двухэтапная терапия вагинальных инфекций. Акушерство и гинекология. 2011;5:90-93. [Radzinsky V.E., Ordiyants I.M., Chetvertakova E.S., Misuno O.A. Two-stage therapy of vaginal infections. Obstetrics and gynecology [Akusherstvo i ginekologiya]. 2011;5:90-93.] (In Russ.)Радзинский В.Е., Ордиянц И.М., Четвертакова Э.С., Мисуно О.А. Двухэтапная терапия вагинальных инфекций. Акушерство и гинекология. 2011;5:90-93. [Radzinsky V.E., Ordiyants I.M., Chetvertakova E.S., Misuno O.A. Two-stage therapy of vaginal infections. Obstetrics and gynecology [Akusherstvo i ginekologiya]. 2011;5:90-93.] (In Russ.)Радзинский В.Е., Ордиянц И.М. БИОС: сравнительная оценка различных схем лечения бактериального вагиноза и неспецифического вульвовагинита. Status Praesens. 2013;1(12):52-55. [Radzinsky V.E., Ordiyants I.M. BIOS: comparative assessment of different treatment schemes of bacterial vaginosis and nonspecific vulvovaginitis. Status Praesens. 2013;1(12):52-55.] (In Russ.)Радзинский В.Е., Ордиянц И.М. БИОС: сравнительная оценка различных схем лечения бактериального вагиноза и неспецифического вульвовагинита. Status Praesens. 2013;1(12):52-55. [Radzinsky V.E., Ordiyants I.M. BIOS: comparative assessment of different treatment schemes of bacterial vaginosis and nonspecific vulvovaginitis. Status Praesens. 2013;1(12):52-55.] (In Russ.)Руднева О.Д., Добрецова Т. А., Маклецова С. А. Под ред. Радзинского В.Е. Рецидивы баквагиноза и лактофлора: от актуальной неодно-начности к практическим решениям. StatusPraesens. 2013, 16 с. [Rudneva O.D., Dobretsova T.A., Makletsova S.A.. Edited by Radzinsky V.E. Recurrence of bacvaginosis and lactoflora: from current ambiguity to practical solutions. StatusPraesens. 2013, 16 p.] (In Russ.)Руднева О.Д., Добрецова Т. А., Маклецова С. А. Под ред. Радзинского В.Е. Рецидивы баквагиноза и лактофлора: от актуальной неодно-начности к практическим решениям. StatusPraesens. 2013, 16 с. [Rudneva O.D., Dobretsova T.A., Makletsova S.A.. Edited by Radzinsky V.E. Recurrence of bacvaginosis and lactoflora: from current ambiguity to practical solutions. StatusPraesens. 2013, 16 p.] (In Russ.)

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