Current treatment modalities for certain urogenital infections in pregnancy

Abstract

K.R. Bondarenko, Yu.E. Dobrokhotova Pirogov Russian National Research Medical University, Moscow, Russian Federation   This article critically reviews paradigm shift in obstetrics over the last three decades regarding the diagnosis and treatment of some infections of female reproductive system during pregnancy. Screening algorithms and treatment approaches to vulvovaginal candidiasis and asymptomatic bacteriuria in the course of gestation approved by clinical protocols worldwide are compared. The article provides the basis for topical application of 2% clotrimazole cream in pregnant women with manifest vulvovaginal candidiasis or asymptomatic vaginal colonization with Candida spp. Novel findings demonstrate that this treatment potentially reduces the rate of preterm birth. Despite conflicting views on the screening for infections in pregnancy, the author argues the tests for asymptomatic bacteriuria after week 14 of pregnancy to prevent severe infections of the upper and lower urinary system and to reduce the risk of preterm birth. 3 g of per os fosfomycin trometalol (Fosfomycin Esparma) is re commended as the first-line choice for asymptomatic bacteriuria in pregnancy. This medication meets the requirements for drug safety and efficacy. Keywords: pregnancy, preterm birth, vulvovaginal candidiasis, urinary infections, asymptomatic bacteriuria, clotrimazole, fosfomycin trometalol. For citation: Bondarenko K.R., Dobrokhotova Yu.E. Current treatment modalities for certain urogenital infections in pregnancy. Russian Journal of Woman and Child Health. 2019;2(3):168–172.