Optimization of Antibacterial Therapy for Nonspecific Vaginitis in Women of Reproductive Age

Abstract

Objective. To study the bacteriological composition and sensitivity of vaginal microflora and to optimize antibacterial therapy in women of reproductive age with aerobic vaginitis and bacterial vaginosis.
 Methods. 160 women (100%) were examined, which were divided into 2 clinical groups with subgroups: the main group - 94 (58,8 %) patients with nonspecific vaginitis, who received treatment according to developed clinical diagnostic algorithms and schemes. The comparison group included 66 (41,2 %) patients with nonspecific vaginitis, who received treatment according to known protocols. Methods: general clinical examination, gynecological examination, microscopic study (microscopy of vaginal smears according to the Amsel, Nugent and Donders criteria), bacteriological seeding and determination of the microflora’s sensitivity to antibacterial drugs on the automatic microbiological analyzer “VITEK 2” (France), statistical.
 Results. In women with AV the highest percentage of sensitivity of vaginal microflora was to moxifloxacin - 30,0 % and there were no resistant pathogens, in patients with BV – sensitivity to secnidazole was 86,3 %. After appropriate antibiotics were prescribed, a significant decrease was established in the main group of Escherichia coli (c2=7,23; P=0,008), Staphylococcus aureus (c2=3,87; P<0,049), Streptococcus agalactiae (c2=3,87; P<0,049) in AV, and a significant decrease of Gardnerella vaginalis (c2=28,20; P=0,001) і Atopobium vaginae (c2=3,87; P<0,049) in BV.
 Conclusion. Establishing the type of causative bacteria, its sensitivity to antibiotics and the appointment of rational antibacterial therapy are likely to improve clinical effectiveness in the near and long terms, reduce frequency of recurrence of nonspecific vaginitis.