RU2234924C1 - Method for treatment of urogenital tract chlamydium infection - Google Patents

Abstract

FIELD: medicine, venerology, urology, gynecology.

SUBSTANCE: method involves administration of phlogenzym in the dose 3 dragees, 2 times per 24 h, 30 min before eating for 14 days and, additionally, antibiotic among the group of tetracyclines or macrolides in standard doses for 10 days beginning from the second day of treatment. Invention promotes to the directed effect of antibiotics of damage focus that, in turn, results to complete elimination of pathogen from body and reducing treatment time.

EFFECT: enhanced effectiveness of treatment.

2 ex

Description

The invention relates to medicine, namely to venereology, gynecology and urology, and can be used to treat patients with urogenital chlamydial infection.

Chlamydia infection (Chlamydia trachomatis) is considered the most common bacterial sexually transmitted pathogen. About 90 million new cases of urogenital chlamydia are registered annually in the world. Chlamydial infection is one of the main causes of the development of chronic inflammatory processes of the urogenital tract and, as a consequence, secondary infertility in women and men around the world (World Health Organization. Global Prevalence and Incidence of Selected Curable Sexually Transmitted Infections. Overview and Estimates. Geneva: WHO, 2001).

Since in the chronic course of chlamydial infection, treatment with antibacterial drugs is not always effective, more and more attention is being paid to pathogenetic therapy. The choice of pathogenetic therapy should be adequate and take into account the chronic nature of the disease, possible complications from the genitourinary organs and reproductive system. The appointment of pathogenetic therapy should be aimed at correcting existing immunological disorders, stopping inflammatory processes, resorption of adhesions and improving microcirculation.

A significant number of methods for the treatment of chlamydia have been developed. However, the etiological cure, especially in the case of treatment of complicated forms of chlamydia, is low. When using only antibacterial drugs, it is effective only in 17.2-25%, and combined antibiotic therapy in 50-70% of cases (Kozlova V.I., Pukhner A.P. Viral, chlamydial and mycoplasma diseases of the genitals. M., 1995; p.138-261; Ilyin II, Kovalev Yu.N., Lysenko OV Reflections on the treatment of urogenital chlamydia // Bulletin of Dermatology and Venereology, 1994; No. 1, p.30-33; Mashkillayson A .L., Gomberg M.A., Solovyov A.M. To the problem of urogenital chlamydia // STD, 1995; No. 5, pp. 28-33; Batyrshina S.V. Principles and methods of treatment of women with chlamydia iosemia and impaired reproductive function. Management tactics. In: Actual issues of venereology and dermatology. Yekaterinburg, 1995, pp. 55-61; Henri-Suchet J. Chlamydia in gynecology (frequency, significance, treatment and prevention) // Actual microbiological and clinical problems of chlamydial infections. M., 1990, S. 46-51).

The work of Sukhikh G.T., Bozhedomov V.A., Malinina E.V. et al. "The therapeutic effect of wobenzym in the complex treatment of urogenital chlamydia and mycoplasmosis" in the collection: "Materials of the II International Conference: Systemic enzyme therapy. M., 1996, pp. 59-64 (prototype). The authors conducted a study to study the therapeutic effect Wobenzym in the complex treatment of urogenital chlamydia.Wobenzym was prescribed 5 tablets 3 times a day (15 tablets per day) in conjunction with traditional antibiotic therapy (doxycycline hydrochloride, ofloxacin), two 10-day courses with a one-week break. treatment of urogenital chlamydia in combination with complete elimination of the pathogen was observed in 87.5% of cases, the authors concluded that the cure with this method of treatment is characterized not only by normalization of clinical parameters, but also by elimination of the pathogen.

However, this method has a number of negative aspects:

- patients noted the inconvenience of taking a large amount of dragees (15 pcs. per day), which was accompanied by unpleasant sensations in the gastrointestinal tract (bloating, discomfort, feeling of fullness of the stomach, loose stools) in the absence of any gastroenterological diseases; - long-term cure rates 6 months after the complex treatment were relatively low - 73.6%.

The objective of the invention is to increase the effectiveness of treatment, reduce the duration of treatment and course doses of medications and reduce side effects from the therapy.

The proposed method for the treatment of chronic chlamydial infection of the urogenital tract is that the patient is prescribed phloenzym 3 tablets 2 times a day (30 minutes before meals) for 14 days. Starting from day 2 of taking phlogenzyme, an antibiotic from the group of tetracyclines or macrolides is used in standard dosages in a 10-day course.

The action of phlogenzyme (Mucos Pharma, Germany) is based on the complex therapeutic effect on the body of purposefully selected enzymes of animal (trypsin) and plant (bromelain) origin in combination with rutoside. The drug is available in the form of tablets, resistant to the effects of gastric juice. Each tablet contains 48 mg of trypsin, 90 mg of bromelain, 100 mg of rutoside.

Under observation were 42 patients with chronic chlamydial infection of the urogenital tract, who were treated by the proposed method. The effectiveness of treatment (complete elimination of chlamydia) was 97.6%. None of the patients revealed subjective or objective side effects or complications from the therapy. Long-term cure rates after 1, 3,5, 5 months after the complex treatment were 97.6%.

Comparison of the proposed method with the prototype shows that the proposed method is more effective. A month after treatment, the absence of chlamydia was found in 97.6% of patients treated by the proposed method, and in 87.5% of patients treated by the prototype method. Long-term results of treatment showed the absence of chlamydia in patients treated by the proposed method, also in 97.6% of cases, and in patients treated by the prototype method, in 73.6% of cases. At the same time, the dose of the medication taken was reduced (6 tablets per day according to the proposed method in comparison with 15 tablets per day according to the prototype; the antibiotic was taken in the proposed method for 10 days, and in the prototype 20 days) and the duration of the course of treatment (14 days according to the proposed method ; two 10-day courses with a weekly break - according to the prototype).

Clinical example.

Patient S., 32 years old. Diagnosis: chlamydial infection of the lower urinary tract.

The patient is ill for 2 years, when chlamydia was first detected in the material from the urethra. He spent 4 courses with antibiotics (rovamycin, sumamed, fromilid), which did not lead to the elimination of chlamydial infection. Results of recent microbiological studies:

- Gram gram urethral smear microscopy - 20-25 white blood cells in the field of view, epithelium, rods, cocci.

- chlamydia detected by direct fluorescence and polymerase chain reaction.

Treatment: phloenzyme was prescribed in 3 tablets 2 times a day (30 minutes before meals) for 14 days. Starting from the second day, an antibiotic is additionally prescribed - clarithromycin 250 mg 2 times a day for 10 days. The total duration of treatment is 14 days. No side effects from the therapy were observed. During the control study 30 days after the end of therapy, chlamydia was not found. At a repeated two-time examination with an interval of 1.5 months (3.5 and 5 months after the treatment), chlamydia was not detected.

Clinical example:

Patient M., 27 years old. Registered in the consultation “Marriage and the family” with a diagnosis of “secondary infertility” was for 2 years. In 2001, she was sent to NGMA to exclude sexually transmitted infections. As a result of the examination, chlamydia was detected by direct fluorescence and polymerase chain reaction. Diagnosis: chlamydial infection of the lower urinary tract, secondary infertility. Repeatedly treated for chlamydial infection (sumamed, macropen, doxycycline).

Treatment: phlogenzyme was prescribed in 3 tablets 2 times a day (30 minutes before meals) for 14 days. Starting from the second day, an antibiotic is additionally prescribed - josamycin 500 mg 3 times a day for 10 days. The total duration of treatment is 14 days. No adverse events from the therapy were noted. During the control study 30 days after the end of therapy, chlamydia was not found. At a repeated two-time examination with an interval of 1.5 months (3.5 and 5 months after the treatment), chlamydia was not detected. Six months later, the woman became pregnant, which ended in a successful birth.

Claims (1)

A method for the treatment of chronic chlamydial infection of the urogenital tract, including systemic enzyme therapy and antibiotic therapy, characterized in that phlozenzyme is prescribed 3 tablets 2 times a day 30 minutes before meals for 14 days and from the second day of treatment an antibiotic from the group of tetracyclines or macrolides is prescribed in standard doses for 10 days.