PURPOSE OF THE STUDY

To study the effect of vaginal use of the drug «Multi-Gyn FloraFem» on the dynamics of clinical symptoms and laboratory parameters in patients with recurrent vulvovaginal candidiasis for the prevention of exacerbations in patients using a combined oral contraceptive (COC) with the composition of drospirenone (DRSP) 3 mg + ethinylestradiol (EE) 30 mcg.

MATERIAL AND METHODS

A study was made of 75 women of childbearing age with recurrent vulvovaginal candidiasis (VVC) and using a combined oral contraceptive with the composition of drospirenone (DRSP) 3 mg + ethinylestradiol (EE) 30 mcg for contraception. All patients were randomized into three groups. A two-stage treatment regimen was used, where oral fluconazole at a dose of 150 mg three times at 72-hour intervals was chosen as the drug of the 1st stage in all groups, then once a week for 6 months. Fluconazole 150 mg once a week for 6 months was used as a therapy for the second stage in patients of the 1st group (n=32) and vaginal gel «Multi-Gyn FloraFem» 1 time per day for 5 days after the end of the main course. Patients of the 2nd group (n=32) received fluconazole 150 mg 1 time per week for 6 months and used vaginal gel «Multi-Gyn Flora-Fem» as an anti-relapse component 1 time in 3 days for 30 days. Patients of the 3rd group (n=30) used only basic therapy with fluconazole once a week for 6 months. The diagnosis of VVC was determined by the result of the dynamics of complaints, clinical studies, microscopic and bacteriological methods. The results of treatment were evaluated after 14 days, 3 and 6 months from the start of the 1st stage of treatment.

RESULTS

The conducted studies have shown that the use of the gel for the normalization of the vaginal microflora «Multi-Gyn FloraFem», both in the long and in the short scheme against the background of the use of COCs containing DRSP mg + EE 30 mcg by patients, made it possible to preserve the vaginal microflora in during the entire period of observation and prevent exacerbation of genital candidiasis in 84.5±4.2% of women. Only in 10±2.7% of observations laboratory confirmations of VVC appeared, possibly associated with other causes, including those transferred during the observation period of ARVI and the appearance of C. nonalbicans (in the control study, C. krusei, C. albicans, C. tropicalis, insensitive to azoles). No side effects (allergic reactions) were found in any of the observations.

CONCLUSION

Our study showed that the addition of the non-hormonal drug «Multi-Gyn FloraFem» in recurrent VVC in women of reproductive age while taking COCs containing DRSP 3 mg + EE 30 mcg, to the standard anti-relapse regimen — fluconazole 150 mcg per 6 months improves the quality of life of patients, both when using a short regimen (5 days), and with an even greater effect with long-term use and increases adherence to the use of hormonal contraception in patients with chronic VVC. The drug is affordable, sold without a doctor’s prescription, convenient for storage and use.