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Possibilities of local therapy of mixed nonspecific bacterial-fungal vaginal infections

https://doi.org/10.21518/ms2025-152

Abstract

Introduction. The consequences of these mixed nonspecific vaginitis are manifested in the aggravation of the course of the disease, the complexity of diagnosis and the choice of therapy.

Aim. Evaluation of the clinical and microbiological efficacy of a complex drug including clindamycin and butoconazole in local therapy of patients with mixed forms of nonspecific bacterial-fungal vaginal infections.

Material and methods. 126 patients with a confirmed diagnosis of “mixed nonspecific bacterial-fungal vulvovaginitis”. The proposed therapy is a vaginal cream containing clindamycin phosphate and butoconazole nitrate (1 dose (5.0 g) for 6 days). Clinical and microbiological efficacy was assessed at 14 days (22 ± 3 days from the start of therapy – stage V2), 1 month (40 ± 3 days from the start of therapy – stage V3) and 3 months (100 ± 3 days from the start of therapy – stage V4) after the end of therapy.

Results. Topical use of a drug containing an antibiotic (clindamycin phosphate) and an antimycotic (butoconazole nitrate) contributes to the leveling of clinical symptoms in the form of itching and dyspareunia, respectively, in 94.45% and 92.9%, pathological whites in 91.3% of women, normalization of the pH of vaginal secretions in 92.1% of patients. Microbiological efficacy at the end of the follow-up period was 88.1% (Hay/Ison Grade 1 and 2), 90.5% (Donders Grade <3) and 86.5% PCR.

Conclusion. Clinical and microbiological evaluation of the use of containing an antibiotic (clindamycin phosphate) and an antimycotic (butoconazole nitrate) as a seven-day therapy, having a wide range of antibacterial and antimycotic activity with good tolerability, has shown high efficacy in the treatment of patients diagnosed with mixed nonspecific bacterial-fungal vulvovaginitis, which allows it to be recommended for the treatment of women with This nosology, and also offers a safe and effective option for empirical therapy of various vaginal infections.

About the Authors

I. O. Borovikov
Kuban State Medical University
Russian Federation

Igor O. Borovikov, Dr. Sci. (Med.), Associate Professor, Professor of the Department of Obstetrics, Gynecology and Perinatology

4, Mitrofan Sedin St., Krasnodar, 350063



I. I. Kutsenko
Kuban State Medical University
Russian Federation

Irina I. Kutsenko, Dr. Sci. (Med.), Professor, Head of the Department of Obstetrics, Gynecology and Perinatology

4, Mitrofan Sedin St., Krasnodar, 350063



O. I. Borovikova
Kuban State Medical University
Russian Federation

Olga I. Borovikova, Postgraduate Student of the Department of Obstetrics, Gynecology and Perinatology

4, Mitrofan Sedin St., Krasnodar, 350063

 



А. S. Magay
Kuban State Medical University
Russian Federation

Anton S. Magay, Postgraduate Student of the Department of Obstetrics, Gynecology and Perinatology

4, Mitrofan Sedin St., Krasnodar, 350063

 



A. V. Novikov
Kuban State Medical University
Russian Federation

Alexander V. Novikov, Student of the Faculty of Medicine

4, Mitrofan Sedin St., Krasnodar, 350063

 



L. A. Filippova
Kuban State Medical University
Russian Federation

Lyudmila A. Filippova, Student of the Faculty of Medicine

4, Mitrofan Sedin St., Krasnodar, 350063

 



References

1. Zakharova TV, Volkov VG. Experience in treating bacterial vaginosis associated with vulvovaginal candidiasis. Akusherstvo i Ginekologiya (Russian Federation). 2016;(11):131–135. (In Russ.) https://doi.org/10.18565/aig.2016.11.131-5.

2. Shang X, Bai H, Fan L, Zhang X, Zhao X, Liu Z. In vitro biofilm formation of Gardnerella vaginalis and Escherichia coli associated with bacterial vaginosis and aerobic vaginitis. Front Cell Infect Microbiol. 2024;14:1387414. https://doi.org/10.3389/fcimb.2024.1387414.

3. Kira EF, Khalturina YV. Modern therapeutic options in the treatment of bacterial vaginosis. Journal of Obstetrics and Women’s Diseases. 2020;69(3):39–45. (In Russ.) https://doi.org/10.17816/JOWD69339-45.

4. Aklilu A, Woldemariam M, Manilal A, Koira G, Alahmadi RM, Raman G et al. Aerobic vaginitis, bacterial vaginosis, and vaginal candidiasis among women of reproductive age in Arba Minch, southern Ethiopia. Sci Rep. 2024;14(1):9813. https://doi.org/10.1038/s41598-024-58654-y.

5. Malova IO, Afanasyeva IG. Bacterial Vaginosis: Is there an alternative to traditional drugs? Meditsinskiy Sovet. 2019;(7):93–103. (In Russ.) https://doi.org/10.21518/2079-701X-2019-7-93-103.

6. Ye L, Yu F, Hu Z, Wang X, Tang Y. Preliminary Study on the Identification of Aerobic Vaginitis by Artificial Intelligence Analysis System. Sichuan Da Xue Xue Bao Yi Xue Ban. 2024;55(2):461–468. https://doi.org/10.12182/20240360504.

7. Maksimovic Celicanin M, Haahr T, Humaidan P, Skafte-Holm A. Vaginal dysbiosis – the association with reproductive outcomes in IVF patients: a systematic review and meta-analysis. Curr Opin Obstet Gynecol. 2024;36(3):155–164. https://doi.org/10.1097/GCO.0000000000000953.

8. Khismatulina IM, Lisovskaya SA, German IE, Mukminova MM. Nonspecific vaginal infections of mixed etiology in women of reproductive age: features of the microbial landscape and results of topical combination therapy. Immunopathology, Allergology, Infectology 2024;(4):22–29. (In Russ.) https://doi.org/10.14427/jipai.2024.4.22.

9. Zong X, Feng Y, Bai H, Wang H, Shang X, Fan L et al. Zhonghua Fu Chan Ke Za Zhi. 2023;58(3):191–197. https://doi.org/10.3760/cma.j.cn112141-20221212-00754.

10. Zhu B, Tao Z, Edupuganti L, Serrano MG, Buck GA. Roles of the Microbiota of the Female Reproductive Tract in Gynecological and Reproductive Health. Microbiol Mol Biol Rev. 2022;86(4):e0018121. https://doi.org/10.1128/mmbr.00181-21.

11. Dobrokhotova YuE, Kazantseva VD, Bondarenko KR. Bacterial vaginosis: modern anti-relapse treatment tactics. RMJ. 2022;(8):61–65. (In Russ.) Available at: https://www.rmj.ru/articles/ginekologiya/Bakterialynyy_vaginoz_sovremennye_protivorecidivnye_strategii.

12. Ncib K, Bahia W, Leban N, Mahdhi A, Trifa F, Mzoughi R et al. Microbial Diversity and Pathogenic Properties of Microbiota Associated with Aerobic Vaginitis in Women with Recurrent Pregnancy Loss. Diagnostics. 2022;12(10):2444. https://doi.org/10.3390/diagnostics12102444.

13. Nunn KL, Clair GC, Adkins JN, Engbrecht K, Fillmore T, Forney LJ. Amylases in the Human Vagina. mSphere. 2020;5(6):e00943-20. https://doi.org/10.1128/mSphere.00943-20.

14. Nakama C, Thompson B, Szybala C, McBeth A, Dobner P, Zwickey H. The Continuum of Microbial Ecosystems along the Female Reproductive Tract: Implications for Health and Fertility. Pathogens. 2022;11(11):1244. https://doi.org/10.3390/pathogens11111244.

15. France MT, Brown SE, Rompalo AM, Brotman RM, Ravel J. Identification of shared bacterial strains in the vaginal microbiota of related and unrelated reproductive-age mothers and daughters using genome-resolved metagenomics. PLoS ONE. 2022;17(10):e0275908. https://doi.org/10.1371/journal.pone.0275908.

16. Borovikov IO, Kutsenko II, Borovikova OI, Andreeva AA, Filippova LA, Avakimyan VA, Nikogda JV. Possibilities of local therapy of recurrent candidiasis against the background of mixed vaginal dysbiosis. Meditsinskiy Sovet. 2023;(15):83–93. (In Russ.) https://doi.org/10.21518/ms2023-295.

17. Antoni Vives J, Cancelo MJ, Losada MÁ, Doménech A. Dequalinium chloride use in adult Spanish women with bacterial vaginosis: an observational study. J Obstet Gynaecol. 2022;42(1):103–109. https://doi.org/10.1080/01443615.2020.1867966.

18. Tazina TV, Bebneva TN, Aleshkina OS, Soyunov MA. Empirical therapy as first-line treatment for vulvovaginal infections Gynecology, Obstetrics and Perinatology. 2022;21(1):129–135. (In Russ.) https://doi.org/10.20953/1726-1678-2022-1-129-135.

19. Sergiyenko GS, Tazina TV, Zhuchkov MV. The possibilities of clindamycin and butoconazole containing vaginal cream in reducing the risk of recurrence of urogenital candidiasis in comorbid patients with bacterial vaginosis. Gynecology. 2018;20(1):68–70. (In Russ.) https://doi.org/10.26442/2079-5696_20.1.68-70.

20. Li M, Zeng Z, Feng H, Cao Y, Zhang Q, Lv T et al. Accurate 16S Absolute Quantification Sequencing Revealed Vaginal Microecological Composition and Dynamics During Mixed Vaginitis Treatment With Fufang FuRong Effervescent Suppository. Front Cell Infect Microbiol. 2022;12:883798. https://doi.org/10.3389/fcimb.2022.883798.

21. Donders GGG, Bellen G, Grinceviciene S, Ruban K, Vieira-Baptista P. Aerobic vaginitis: no longer a stranger. Res Microbiol. 2017;168(9-10):845–858. https://doi.org/10.1016/j.resmic.2017.04.004.

22. Lin Y, He F, Wu L, Xu Y, Du Q. Matrine Exerts Pharmacological Effects Through Multiple Signaling Pathways: A Comprehensive Review. Drug Des Devel Ther. 2022;16:533–569. https://doi.org/10.2147/DDDT.S349678.

23. Asghar S, Khan JA, Mahmood MS, Arshad MI. A Cross-sectional Study of Group B Streptococcus-Associated Sepsis, Coinfections, and Antibiotic Susceptibility Profile in Neonates in Pakistan. Adv Neonatal Care. 2020;20(4):E59–E69. https://doi.org/10.1097/ANC.0000000000000701.

24. Genovese C, D’Angeli F, Di Salvatore V, Tempera G, Nicolosi D. Streptococcus agalactiae in pregnant women: serotype and antimicrobial susceptibility patterns over five years in Eastern Sicily (Italy). Eur J Clin Microbiol Infect Dis. 2020;39(12):2387–2396. https://doi.org/10.1007/s10096-020-03992-8.

25. Zhang Y, Lyu J, Ge L, Huang L, Peng Z, Liang Y et al. Probiotic Lacticaseibacillus rhamnosus GR-1 and Limosilactobacillus reuteri RC-14 as an Adjunctive Treatment for Bacterial Vaginosis Do Not Increase the Cure Rate in a Chinese Cohort: A Prospective, Parallel-Group, Randomized, Controlled Study. Front Cell Infect Microbiol. 2021;11:669901. https://doi.org/10.3389/fcimb.2021.669901.

26. Wang Z, He Y, Zheng Y. Probiotics for the Treatment of Bacterial Vaginosis: A Meta-Analysis. Int J Environ Res Public Health. 2019;16(20):3859. https://doi.org/10.3390/ijerph16203859.


Review

For citations:


Borovikov IO, Kutsenko II, Borovikova OI, Magay АS, Novikov AV, Filippova LA. Possibilities of local therapy of mixed nonspecific bacterial-fungal vaginal infections. Meditsinskiy sovet = Medical Council. 2025;(4):114-123. (In Russ.) https://doi.org/10.21518/ms2025-152

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ISSN 2079-701X (Print)
ISSN 2658-5790 (Online)