Медицинский совет (Oct 2020)
Therapeutic approaches in the treatment of vulvovaginal candidiasis
Abstract
According to world statistics, vulvovaginal candidiasis is a very common disease with a serious tendency to recurrence and chronic-ity, which makes it a fundamentally significant medical and social problem, the solution of which is becoming a priority task facing obstetricians and gynecologists. The attention of doctors should be focused on the search for optimal treatment regimens that meet all the requirements for therapeutic approaches, the introduction of which into clinical practice should lead to a significant decrease in the incidence of the disease and its chronicity in the population, and also on increase in the relapse interval, which will certainly be reflected in improving the quality of life of women. Analysis and comparison of the effectiveness of antifungal drugs on the modern pharmaceutical market, and the choice of the most effective and safe drug can be the key to success in combating the widespread prevalence of vulvovaginal candidiasis.The article presents the etiological aspects of vulvovaginal candidiasis, demonstrating an increase in the importance of Candida non-albicans in the pathogenesis of the disease, which is confirmed by high rates of disease prevalence, including chronic and recurrent forms. The mechanisms of vulvovaginal candidiasis development and diagnostic methods that allow to assess the state of vaginal microcenosis most adequately are considered. The negative impact of vulvovaginal candidiasis on the course of pregnancy and possible outcomes for both the mother and the fetus are also described. Special attention is paid to the ability of fungi of the genus Candida to form associations of microorganisms - biofilms, which create an obstacle to many antifungal drugs. The problem of resistance of Candida fungi to a number of antifungal drugs is highlighted. Data on the uniqueness of the composition and action of sertaconazole and the effectiveness of its use, which is confirmed by studies, including in a group of pregnant patients, are presented. The article analyses indicators of safety of sertaconazole and criteria of continuity.
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