Vulvovaginal candidiasis

Lower parts of the genitourinary system women are the ecological system, including stratified squamous epithelium of the vagina, cervix columnar epithelium and vaginal secretions. Each of these habitats is characterized by a specific microbial population.

The microflora of the vagina, along with other factors, determines the colonization resistance. As you know, in the vaginal microcenosis includes more than 40 species of microorganisms, which are 93-97% H2O2-producing lactobacilli. About 20% of nonpregnant women of reproductive age are determined by yeast-like fungi Sandida related to opportunistic pathogens, the realization of the pathogenic properties of which occurs in the presence of exogenous and / or exogenous risk factors.

At present, fungal urinary tract detected in 65 - 75% of cases in women with vulvovaginal yespetsificheskim. Vulvovaginal candida causes the spread of infection is widespread use of antibiotics and other antibacterial drugs, corticosteroids, cytotoxic drugs, impaired function of the endocrine organs, the immune system, pregnancy, etc.

The choice of method of treatment depends on many factors: the form of the disease, the general condition of patients, the priorities of patients and physicians.

The advantage of systemic antimycotics is the uniform distribution to all organs and tissues, the effect on the agent of any location, convenience, high efficiency. Means of systemic therapy for candidiasis most often used fluconazole. However, we know that genetically resistant C.crusei to fluconazole, C.glabrata of fluconazole dose-dependent. Therefore, if the diagnosis is impossible to culture, is appointed antimycotics the most broad-spectrum - itraconazole.

Itraconazole has a high efficiency and advantages in the treatment of fungal infections compared with other systemic drugs: high potency, broad spectrum antimycotic action, high bioavailability, slow elimination from tissues and organs, low toxicity, minimal severity of adverse reactions, anti-inflammatory and immunostimulatory effects (D Moors . I., Bondarenko, GM, 1999).

In the appointment of medicines for the treatment of any disease, including vulvovaginal candidiasis, in front of the clinician is the problem of choice of original or generic products. An active policy of companies - manufacturers of original drugs - contributes to a negative attitude toward the very notion of "generic", but according to some researchers, this position for no reason (OB Taliban, 2006). In fact, generic prescribing, the clinician should have information about its pharmaceutical and therapeutic equivalence of the original drug.

Concept ═ "Pharmaceutical equivalence" means that the compared drugs contain the same active substance in equal numbers and at the same dosage form and meet the same standards of similar (EMEA. The rules governing medicinal products in the European Union. Investigation of Bioavailability and Bioeguivalence. 1998 . Vol. 3C. P.231-244).

═ The obvious question is whether the information on the availability farmakoekvivalentnosti original and generic drugs, believing that they possess the same therapeutic equivalence? To answer you can contact the American and European definitions of "therapeutically equivalent medicinal product to another if it contains the same active substance and the results of clinical trials is characterized by the same efficacy and safety as the comparator drug, the efficacy and safety is established. "

Лекарственной формой системного антимикотика Микотрокс (итраконазол) является капсула, как и оригинального препарата орунгал. In 2006 the pharmaceutical market of Belarus appeared drug itraconazole Mikotroks production of "Farmakar." Dosage form systemic antimycotics Mikotroks (itraconazole) is a capsule, as well as the original drug Orungal. Farmakokiketicheskaya (bio) equivalence Mikotroksa proved in this research by the manufacturer "Farmakar" (Palestine).

Insufficient number of clinical observations in Belarus to study the efficacy of treatment Mikotroksa vulvovaginal candidiasis justifies the need for further studies to evaluate the therapeutic efficacy of the drug.

We observed 26 patients with vulvovaginal candidiasis: in 9 of them are diagnosed with acute, 17 - chronic recurrent VC.

The most common cause of acute candidiasis was the antibiotic (6 patients), in 2 patients candidiasis was triggered by the use of oral contraceptives and in one patient the cause was not possible.

The diagnosis of chronic vulvovaginal candidiasis was placed under the condition that the woman mentioned 4 or more relapses within one year. All patients in this group periodically received topical and systemic therapy with antimycotics various short-term effect.

Clinical examination and microscopy of preparations of smears of scrapings from the cervical canal of the uterus and the posterior vaginal fornix. All the patients were excluded urogenital trichomoniasis, chlamydia, mycoplasmosis, gonorrhea and other bacterial infections. In smears of scrapings from the genital organs were found spores, mycelial filaments and yeast-like fungi pseudomycelium genus Candida. Bacteriological examination of 23 patients identified C.albicans, in 2 - C.tropicalis, in one - C.crusei.

Patients with acute vulvovaginal candidiasis Mikotroks administered 200 mg 2 times daily for 1 day for chronic relapsing - 200 mg 1 time a day, 7 days (main course), to prevent a recurrence - 200 mg once a day once the first day periods of 4-6 months. в удобной для лечения вульвовагинального кандидоза упаковке: 4 капсулы по 100 мг для острого кандидоза и 14 капсул по 100 мг для других форм. It should be noted that the pharmaceutical company "Farmakar" supplies in pharmacies Mikotroks in handy for the treatment of vulvovaginal candidiasis package: 4 capsules of 100 mg for acute candidiasis, and 14 capsules of 100 mg for the other forms.

All patients tolerated the therapy well, noted the ease of preparation. All patients with vaginal candidiasis after therapy with the drug control Mikotroks conducted clinical and laboratory study.

Clinical manifestations of the disease resolved within the first two days in all patients with acute candidiasis, and 7 - chronic. The remaining 10 patients with chronic candidiasis recovery occurred by the end of primary treatment. Against the background of preventive therapy for clinical relapse in 11 patients not recorded, 6 were not expressed and resolved without treatment.

Thus, studies have shown a high efficacy and good tolerability of systemic antimycotics in the treatment of Mikotroksa various forms of vulvovaginal candidiasis. Ease of use and lack of side effects makes it possible to recommend Mikotroks not only for treatment but for prevention of recurrent vulvovaginal candidiasis.