Doctors have named ways to treat bacterial vaginosis

Bacterial vaginosis (BV) is one of the most common diseases in women. It often becomes the reason for contacting gynecologists, but the high frequency of relapses remains a problem. This is stated in an article published in the Russian Medical Journal.

"Bacterial vaginosis can affect the development of many complications, including premature birth and pelvic inflammatory disease," experts say.

The human vaginal microbiome consists mainly of lactobacilli, which maintain an optimal pH level (less than 4.5), creating an unfavorable environment for pathogenic microorganisms. However, with the development of bacterial vaginosis, an imbalance of the microbiota occurs, which leads to the predominance of microorganisms such as the bacteria Gardnerella vaginalis and Prevotella spp., which can cause symptoms of inflammation and relapses of the disease.

Until a few years ago, there was no clear answer to the question of how to treat this disease, but today standard therapy includes antibiotics — metronidazole and clindamycin. These drugs show good results in 80-90% of cases, however, according to the researchers, the recurrence rate remains high, reaching 69% after 12 months. This may be due to the formation of biofilms that protect bacteria from the effects of antibiotics, making treatment ineffective.

New research shows that resistance to metronidazole increases significantly with each subsequent episode of the disease. Of the 50 strains of Gardnerella vaginalis, 68% were found to be resistant to metronidazole, and only 24% to clindamycin. In addition, clindamycin has proven to be more effective in the treatment of recurrent BV, which is confirmed by research.

Despite the high level of resistance, there are alternatives to traditional treatment. For example, probiotics have demonstrated effectiveness in restoring normal vaginal microflora, but their use remains controversial. Some experts believe that drugs that promote the restoration of the natural microbiome, such as lactic acid with glycogen, are more promising, which helps prevent relapses.

The use of phages that are specific to Gardnerella vaginalis also promises good results, showing high efficacy in recurrent BV.

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Alexander Umnov, a lecturer at the Department of Surgery at the Medical Faculty of the State University of Education, told Izvestia on June 19 that chronic cystitis is most common in women due to anatomical features and changes in hormonal status. It can also develop as a result of inflammation of the pelvic organs and when stones are found in the bladder with urolithiasis (ICD). Before starting treatment, it is necessary to send urine for culture in order to know which bacterium to treat. To reduce pain, the specialist recommended taking nonsteroidal anti-inflammatory drugs (NSAIDs).

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