Objective: to evaluate the efficiency and compliance with Polygynax treatment for vulvovaginitis caused by the aerobic and mixed microflora in reproductive-aged women. Subjects and methods. The investigation enrolled 36 reproductive-aged women diagnosed with aerobic and mixed vulvovaginitis. It was conducted in accordance with international standards and GCP guidelines. A polygynax vaginal capsule was given before bedtime for 12 days. Therapeutic efficiency was evaluated by clinical, expanded colposcopic, and pH-metry findings, and the status of vaginal microbiocenosis, by determining the major groups of opportunistic microorganisms using a real-time quantitative polymerase chain reaction assay. Results. It was established that the pathogenetically sound use of a combination of two broad-spectrum antibiotics and an antimycotic agent enabled polyvalent treatment with no negative effects of the antibiotics on the normal vaginal microflora. On the strength of clinical findings, the authors substantiated the efficiency of a 12-days treatment cycle as the most optimal method to completely eliminate pathogens and to reduce recurrence rates. Acting selectively on facultative anaerobic bacteria (Enterobacterium spp., Streptococcus spp., Staphylococcus spp.), Polygynax failed to eliminate Lactobacillus spp. and promoted the suppression of aerobic microbial growth and the creation of optimal conditions for the growth of proper lactoflora, ensuring the colonization resistance of a vaginal biotope and enhancing the total efficiency of treatment. Conclusion. Polygynax is the drug of choice for treating vulvovaginitis caused by the aerobic and mixed microflora in reproductive-aged women. The authors declare no conflicts of interest.