home Auditorium 7 Treatment of Gardnerella with metronidazole scheme. Prevention of vaginal dysbiosis. Preparations for restoring normal vaginal microflora

Treatment of Gardnerella with metronidazole scheme. Prevention of vaginal dysbiosis. Preparations for restoring normal vaginal microflora

Gardnerellosis or bacterial vaginosis is a gynecological disease characterized by changes in the vaginal microflora. The term vaginal dysbiosis is also used in medicine to refer to this pathology.

It does not cause inflammatory processes, is a fairly common female disease and involves the treatment of gardnerella in the body.

In a healthy female body, 95% of the entire vaginal biocenosis is made up of lactic acid bacteria, which play a direct role in creating a natural protective barrier of the vaginal mucosa.

The remaining 5% is occupied by about 300 other various microorganisms, including gardnerella, and this is the norm.

The vaginal microflora is extremely sensitive to both various external and internal influencing factors.

The causes of gardnerellosis in women can be a variety of processes:

puberty in adolescents;
decreased immunity in general;
diseases of the endocrine system;
stress instability;
intestinal dysbiosis;
disruption of the menstrual cycle;
violation of intimate hygiene;
lack of regular sexual activity;
frequent change of sexual partners;
taking antibiotics and contraceptives;
long-term use of intrauterine contraception;
pregnancy and childbirth;
artificial termination of pregnancy;
various surgical procedures;
chemotherapy;
worsening chronic ailments;
climate change and dietary changes.

All of the above conditions can provoke a decrease in the number of beneficial lactobacilli in the body. As a result, Gardnerella has the opportunity to actively develop and colonize the internal reproductive organ.

Symptoms and manifestations of vaginal dysbiosis

Women's symptoms of the disease are simple and understandable. They are observed on an ongoing basis in the form of profuse white, grayish or yellowish discharge from the genital tract. Upon visual examination, you can often detect a foamy structure of the discharge, which can be easily removed with a cotton swab.

The main symptom is accompanied by a pungent odor characteristic of rotten fish.

Other manifestations may include redness and itching of the external genital organs, burning during urination, as well as discomfort during sexual intercourse.

Medical diagnosis of gardnerellosis

If you suspect bacterial vaginosis, it is not recommended to start eliminating the problem on your own. This disease can occur along with other infections, so it requires proper diagnosis and treatment under the supervision of a specialist.

In order to identify or refute the presence of gardnerellosis, several laboratory tests are carried out.

Microscopy of a vaginal smear is considered the most effective. The final diagnosis must be confirmed by an analysis for isonitrile - the presence of this substance in a woman’s body indicates the presence of an abundance of gardnerella in the vaginal microflora.

When bacterial vaginosis is detected, additional tests are carried out for possible concomitant pathologies, as well as for the sensitivity of the pathogens to various drugs, after which, based on the results and the general condition of the patient’s body, a suitable treatment for gardnerellosis is prescribed.

Features of treatment of vaginal dysbiosis

Prescribing drugs to eliminate bacterial vaginosis is necessary only if the patient is not pregnant. This disease does not pose a threat to the life of a woman or her unborn baby.

Therefore, therapy can be postponed until the birth of the child. Only in some cases, from the second trimester, the doctor can prescribe certain drugs that have no contraindications during pregnancy.

The choice of medications is a very responsible process, since the wrong selection of medications for each individual patient can only aggravate her disease. Any woman who has encountered such an unpleasant pathology must know how to treat the pathogenic microorganism Gardnerella.

However, only a doctor has the right to prescribe specific medications for her illness.

Gardnerellosis is not classified as a sexually transmitted sexually transmitted disease, but in order to avoid the transmission of harmful bacteria between partners, it is worth refraining from sexual relations during the period of therapy. In addition, both partners must undergo treatment, otherwise an exacerbation of the disease will occur again.

Treatment regimen for bacterial vaginosis

To eliminate bacterial vaginosis in women, various forms of medication are used: vaginal suppositories, suppositories, gels and ointments for local or external treatment, as well as tablets and capsules for oral use.

In addition, along with the main drugs, additional medications are often prescribed to increase the body's immunity.

The primary goal of disease therapy is the elimination of all harmful microorganisms, including those found along with Gardnerella. Antibiotics and antiseptics are used for this. At the same time, in order to prevent the appearance of mycosis in cleaned areas of the vaginal mucosa, antifungal drugs are included in the complex of drugs.

An important role in the prevention of bacterial vaginosis belongs to restorative therapy of the vaginal microflora, which contributes to the restoration of the normal number of lactic acid bacteria in the genitourinary system. During this period, the intestines especially need bifidobacteria, and to smooth out the load on the liver due to antibiotics taken, doctors prescribe hepatoprotectors.

There can be no question as to what specific medications should be introduced in the treatment of gardnerellosis. Even simultaneous therapy for two partners often involves different medications. For this reason, self-medication based on information obtained outside of medical consultations is strongly not recommended.

Any information from free sources about certain medications is presented for substantive review and further discussion at an appointment with a specialist.

McMirror Complex

The medicine for combating single or chronic vaginal dysbiosis Macmiror is well tolerated and has a beneficial effect on the recovery of many patients. An antiseptic with a broad spectrum of action eliminates gardnerellosis not only as an autonomous disease, but also with associated infections.

Macmiror is produced in the form of tablets, as well as in combination with gel or vaginal suppositories and is used according to doctor’s prescriptions. The duration of treatment is determined by the degree of neglect of the disease. The medicine is contraindicated in case of sensitivity to the composition or in case of impaired renal function.

Vaginal suppositories Hexicon

Hexicon– female assistant to avoid gynecological infections. If you have unprotected sexual contact with a casual partner, it is recommended to use the medication no later than two hours after its completion.

This is an antibacterial agent that is used for both preventive and therapeutic purposes. Hexicon effectively fights pathogens of vaginal dysbiosis without causing harm to lactobacilli.

The medicine retains its properties even when used during menstruation, and is contraindicated only in case of personal intolerance to the components of the composition.

Is an antibiotic a guarantee of recovery or a provocation of relapse?

The overwhelming majority of doctors will answer definitely: the key to recovery. Despite the fact that the use of antibiotics is precisely one of the reasons for the occurrence of an excess of gardnerella in the female body, in most cases only chemical substances can help get rid of this disease.

90% of patients are cured thanks to the right antibiotic.

The maximum effect of therapy is achieved in the first stages of the disease. In this case, the second stage is the restoration of the vaginal microflora. The faster the harmful microorganisms are destroyed, the shorter the course of treatment.

Active ingredient: Metronidazole

Metronidazole is considered to be one of the best antibiotics for combating pathogens of vaginal microflora. The substance comes in several forms: tablets, vaginal suppositories, gels and injection solutions. Metronidazole has a beneficial effect on the elimination of Gardnerella, destroying its DNA structure.

The medicine has serious contraindications. It is prohibited to use medications containing Metronidazole while breastfeeding and during pregnancy until the second trimester. In addition, even the smallest dose of alcohol during the use of the substance can lead to Antabuse-like syndrome, which is characterized by a sharp deterioration in the general condition of the body and the formation of an aversion to alcoholic beverages.

The most popular trade names of drugs based on Metronidazole:

Trichopolum;
Metrogil;
Flagyl;
Klion;
Batsimex.

Active ingredient: Clindamycin

Clindamycin has a wide spectrum of action, destroying not only gardnerella, but also many other pathogens. The antibiotic is produced in the form of capsules, vaginal cream, suppositories, gel for external use, as well as ampoules with solution for intravenous and intramuscular administration.

Medicines similar in content of the active substance Clindamycin:

Dalatsin;
Clindahexal;
Zerkalin;
Clindacin.

Active ingredient: Ornidazole

Many modern specialists give their preference to Ornidazole. Typically, in cases of advanced bacterial vaginosis, tests also identify the causative agents of diseases such as chlamydia, trichomoniasis and many others.

Due to its wide spectrum of action, Ornidazole is able to replace a complex of several different drugs, even affecting infections that may not have been detected during research.

The rapid action of the tablets helps you feel positive changes within 2 hours after taking them.

Contraindications for the medication apply to nursing mothers, the first trimester of pregnancy, blood pathologies, as well as neurological diseases.

Antibiotics for the treatment of vaginal dysbiosis containing Ornidazole:

Meratin;
Dazolic;
Tiberal;
Orgil;
Lornizole.

Active ingredient Doxycycline

Doxycycline helps eliminate multiple sexually transmitted infections. Like Ornidazole, it can save the patient from prescribing several medications at the same time, while remaining effective in the fight against each existing disease, acting quickly and without causing complications.

Doxycycline is contraindicated in cases of intolerance to the composition, pregnancy, breastfeeding and in the case of pathologies of the gastrointestinal tract.

Trade names of medications that contain Doxycycline:

Unidox Solutab;
Vibramycin;
Doxilan.

Prevention of vaginal dysbiosis

Unfortunately, it is impossible to protect yourself 100% from such an unpleasant ailment as dysbiosis of the vaginal microflora, but taking a number of preventive measures can significantly reduce the risk of contracting gynecological infections in the future.

All you need is:

lead a healthy lifestyle, strengthen the immune system;
do not self-medicate;
use condoms when changing sexual partners frequently;
carefully observe the rules of personal hygiene;
avoid stress and conflict situations;
restore the body after taking the necessary chemicals;
1-2 times a year, even if you feel excellent, visit the gynecologist’s office.

Simple recommendations will help you avoid a lot of painful consequences that women at any age are so susceptible to. You just have to make it a habit to take care of yourself and your body, and many health problems will disappear on their own.

It is important to remember that health is a priceless treasure that must be protected.

In our body there are a huge number of not only harmful, but also beneficial bacteria. They live everywhere: on the surface of the skin, in the intestines, on the mucous membranes and in the vagina. Thus, almost every organ has its own individual microflora, which ensures its normal functioning. The beneficial bacteria that live in the vagina allow it to fight various infections. But quite often the delicate balance of microflora is disrupted, resulting in more harmful microbes, the most common of which are Gardnerella. This leads to the development of the disease of the same name, which causes harm to the body and requires treatment.

Definition of gardnerellosis in women

Gardnerellosis, or bacterial vaginosis, is a pathological condition in which the gardnerella microorganism predominates in the vagina. It is a tiny bacterium that under normal conditions also lives in the human body along with many others. It is believed that in a healthy woman, acidifying lactobacilli predominate in the vagina, which creates an optimal environment. If this ratio is violated, gardnerellosis occurs with all the accompanying symptoms.

The predominance of Gardnerella in the vaginal microflora is called bacterial vaginosis

The disease occurs in both women of all ages and men. Representatives of the stronger sex suffer from the disease much less frequently, since they have a smaller volume of mucous membrane compared to girls.

What number of microorganisms in a smear is considered normal?

If the number of Gardnerella exceeds the permissible values, the patient begins to develop the main symptoms of the disease. Under normal conditions, this bacterium can also be detected in tests. The following indicators are important for diagnosis:

10 5 –10 6 microorganisms in a smear of a healthy woman is considered normal;
10 7 –10 9 - indicates persistent infection;
10 4 microorganisms in a smear during pregnancy is a cause for concern.

Can gardnerella be in the mouth?

If the disease exists in the body for a long enough time (six months or more), the bacteria gradually spread through the bloodstream and migrate into the oral cavity. Infection can also occur through unprotected oral sex. Gardnerella settles on the oral mucosa and begins to actively grow and multiply, accumulating in the area of the tonsils and pharynx. This often ends with the development of inflammatory processes (stomatitis, pharyngitis, laryngitis).

Gardnerellosis of the oral cavity is accompanied by the formation of plaque on the mucous membrane

Table: difference between gardnerellosis and thrush

Comparative feature	Gardnerellosis	Thrush
The type of microorganism that causes the disease	Bacterium
What does discharge look like?	Greenish-brown, cloudy	White, yellowish
Existing specific odor	Spoiled fish or rotten meat, pungent	Sourish, curdish, barely perceptible
Number of allocations	Up to 250 milliliters per day	50–200 milliliters
Increased symptoms after sexual intercourse	Expressed	Virtually absent
Damage to other organs and systems	Very rare	Oral cavity, gastrointestinal tract

Existing varieties of the disease

Classification of the disease according to the course of the pathological process:

acute (occurs when a large dose of the pathogen enters the body through sexual contact, symptoms increase over 2–3 days);
subacute (forms in one and a half to two weeks);
chronic (exists for six months);
recurrent (phases of exacerbation followed by remission).

Varieties of the disease according to the nature of the discharge:

serous form - the yellow tint of the discharge predominates;
purulent - predominantly green color of the secretion;
fibrinous - there are bloody streaks in the discharge.

Classification of the disease according to the presence of secondary infection:

isolated gardnerellosis;
combination with:
- chlamydia;
- syphilis;
- trichomoniasis;
- gonorrhea;
- candidiasis.

Why does gardnerellosis occur?

For such a disease to develop, not only the presence of bacteria is necessary, but also some active factors. Most often these include:

frequent change of sexual partners;
uncontrolled use of antibacterial drugs;
daily douching;
using regular soap as an intimate hygiene product;
visiting public places such as baths, saunas, swimming pools, gyms;
neuro-emotional shocks;
wearing tight underwear made of synthetic fabrics;
work in conditions of high temperature and humidity;
infectious diseases;
pathologies of the immune system (HIV, primary bone marrow damage).

Ways of transmission of the disease

The disease can occur in a completely healthy woman when the normal microflora of the vagina is disrupted, even if she has not had unprotected sexual intercourse. However, the leading route of infection remains sexual (oral, anal and vaginal penetration have the same risk of infection). Gardnerellosis can also be transmitted by wearing shared underwear or using insufficiently treated sex toys.

Length of incubation period

On average, clinical symptoms of the disease begin to appear 2–14 days after infection. Their intensity depends on the patient’s age, her state of health and the presence of other sexually transmitted diseases.

In elderly people, in 80% of cases the disease is practically asymptomatic, which is associated with slower metabolic processes.

Video: the doctor talks about the peculiarities of the disease

Main symptomatic signs of pathology

Bacterial vaginosis is characterized by a predominance of local manifestations over general ones. The disease progresses extremely slowly, and an increase in symptoms is observed after a viral infection (ARI, cold), stress, physical activity or sexual activity.

Main symptoms of the disease:

Pain in the pelvic area. It has a weak aching character, the intensity increases with urination. During menstruation, the unpleasant sensations intensify several times, becoming constricting and cramping.
Pathological discharge. They have an unpleasant odor that can be felt several meters away, as well as a yellow, brown or green color. The discharge is quite difficult to wash off from clothes and can overfill your panty liner.
Swelling of soft tissues. The labia minora and clitoris swell, become extremely sensitive and sharply painful. After some time, in the absence of wiping and the use of absorbent wipes, a dark coating appears on them, which is easily cleaned off.
Itching and burning when urinating indicate the penetration of bacteria into the urethra and bladder. This symptom occurs in the later stages of the development of the disease.

Gardnerellosis and childbearing

With a long-standing disease, the likelihood of becoming pregnant decreases every year. If conception does occur, the expectant mother faces a huge risk of infection of the baby: bacteria enter the fetus’s body through the baby’s place. There is a high probability of infection during childbirth.

Symptoms of the disease intensify during pregnancy: the woman experiences unbearable itching and burning, and the amount of discharge increases to 300–350 milliliters per day. Often, during a night's sleep, the victim injures the mucous membrane of the external genitalia with her nails, which ends with the addition of a secondary infection.

I had the opportunity to participate in the delivery of a woman who had suffered from gardnerellosis for a long time. She was unable to cure the disease before pregnancy, as a result of which the baby was also confirmed to have this infection. The child was born much prematurely, as a result of which he could not breathe on his own. Doctors decided to nurse the baby in intensive care. After a few months he began to recover, but in the future such an infection causes a serious lag in physical and neuropsychic development from his peers.

How is the disease diagnosed?

The external manifestations of gardnerellosis have similar symptoms to many other pathologies that are sexually transmitted. This makes making a diagnosis much more difficult. Bacterial vaginosis must be differentiated from:

Remember that before visiting a gynecologist and taking a smear, you should not douche the vagina with antiseptic solutions. During my time working in a medical laboratory, I more than once had to deal with the fact that women themselves washed off all the pathogenic microflora; as a result, the study had to be redone again. If you want to get a reliable result, it is recommended to postpone hygiene measures for some time. This is the only way to identify the disease at an early stage.

Methods to confirm the diagnosis:

Leading methods of treatment of gardnerellosis in women

Treatment of bacterial vaginosis is based on normalizing the vaginal microflora. For this, doctors use not only pharmaceuticals, but also a special diet. And also during the recovery period, it is permissible to use various physiological procedures that help strengthen the immune system. In most cases, treatment is mandatory for the disease. Episodes of self-relief of the disease without drug intervention are extremely rare (mainly in young patients).

A woman's sexual partner requires therapy only if he also has elevated gardnerella levels. To do this, a man needs to undergo special tests from a urologist (smear from the urethra).

Video: doctor’s opinion on the need for therapy

Treatment of illness with pharmaceuticals

Drug therapy for gardnerellosis includes the use of both local and general medications. The former can be used in the form of suppositories and douching solutions, as well as in the form of ointments and gels. The latter are represented by tablets, capsules and injections for intramuscular or intravenous administration. The duration of therapy and the choice of drugs is determined by the gynecologist. Self-treatment can lead to aggravation of existing problems in the body.

Gardnerella is sensitive to antimicrobial agents. That is why they are the first group of drugs that help cope with the disease.

Local medications used to combat the disease:

Antibiotic suppositories help prevent the growth of gardnerella and its further development in the body. The most commonly used drugs are:
- Metronidazole;
- Clindamycin;
- Acylact;
- Iodoxide;
- Hexicon.
Antifungal ointments and suppositories prevent the development of fungal microflora and prevent thrush from forming. For this purpose use:
- Nystatin;
- Pimafucin;
- Levorin;
- Fluconazole;
- Flucostat.
Suppositories containing a large number of lactobacilli help normalize the internal environment of the vagina. The most famous drugs:
- Lactobacterin;
- Vaginorm-S;
- Vagilak;
- Lactozhinal.
Antiseptic rinses help remove harmful microflora. For this purpose, dilute solutions of Miramistin, Chlorhexidine, Furacilin are used.

Photo gallery: drugs for local therapy for gardnerellosis

Polygynax - suppositories with an antibiotic that affects gardnerella Clotrimazole helps prevent thrush Lactonorm promotes the growth of lactobacilli Miramistin creates conditions for the death of harmful bacteria

Systemic drugs

Medicines for systemic treatment of the disease:

Antibiotics in tablets and capsules are used when local therapy does not bring the expected effect. The most common drugs:
- Azithromycin;
- Ornidazole;
- Dalatsin;
- Unidox Solutab.
Non-steroidal anti-inflammatory drugs help get rid of itching and burning, and also reduce the severity of discomfort in the pelvic area. For this purpose use:
- Diclofenac Sodium;
- Indomethacin;
- Ibuprofen;
- Pyroxyfer;
- Ortofen;
- Rodanol;
- Celecoxib;
- Rofecoxib;
- Viox;
- Celebrex;
Immunostimulants improve the recovery processes occurring in the body, promoting the formation of new cells. The most famous medications in this group:
- Viferon;
- Wobenzym;
- Amiksin;
- Polyoxidonium;
- Tsitovir.

Photo gallery: drugs for systemic therapy of gardnerellosis

Doxycycline is an antibiotic that causes the death of gardnerella Meloxicam relieves inflammation Immunal helps strengthen the immune system

Traditional medicine as an aid

Quite often, patients do not have the opportunity to see a doctor immediately (business trip, vacation), or the doctor’s appointment is scheduled a few days later, but the discomfort continues to overcome. In these cases, the use of traditional medicine is acceptable. Various douches and tampons will help get rid of the main manifestations of the disease and make the wait easier. Remember that such treatment will not completely solve the problem, since pharmaceuticals are required to restore normal microflora.

I happened to encounter a patient who completely abandoned traditional therapy, preferring to use herbs and plants to eliminate bacterial vaginosis. Regular douching with high-dose solutions led to the fact that the patient not only did not cure gardnerella, but also acquired a serious chemical burn of the vaginal mucosa. The victim was taken by ambulance to the gynecology department, where she underwent reconstructive plastic surgery. Unfortunately, as a result of this procedure, the woman has lost sensitivity and has problems with sex life.

The most popular folk recipes:

Table: physiotherapy in the treatment of the disease

Name of the technique	How is the procedure performed?	Main effects
Radon baths	Immersion of the patient waist-deep in water enriched with this chemical element	Causes the death of most pathogenic microorganisms without causing damage to normal microflora
	Targeted impact of tiny impulses on specific areas of the body	Helps accelerate recovery and regeneration processes in the human body
Medicinal electrophoresis with anti-inflammatory drugs	Introduction of medications into the body using current	Faster and more efficient administration of the substance and its distribution in soft tissues
Inductothermy	Application of magnetic fields of different intensities	Reducing discomfort, preventing the formation of adhesions

Photo gallery: physiotherapy in gynecology

Radon baths cause the death of pathogenic microbes Electrical stimulation accelerates the formation of new cells Drug electrophoresis is used to administer anti-inflammatory and antibacterial agents

Changes in diet and lifestyle for gardnerellosis

To restore normal vaginal microflora, doctors recommend that women follow a certain diet. To do this, you must adhere to the following rules:

consume only fresh and natural products without chemical additives (you can buy them at the market or from private sellers);
Be sure to have breakfast, lunch and dinner. There should also be two snacks so that the breaks between meals do not last longer than three hours;
drink up to one and a half liters of clean water daily;
stop drinking alcohol;
bake, stew or boil food so that it retains vitamins;
do not eat sweets, as they contain a lot of fast carbohydrates and sugars, which create an optimal environment for the growth of bacteria;
reduce the amount of salt to 5 grams per day.

What foods should you include in your diet:

Rules for women during the treatment period

During treatment for gardnerellosis, you will have to slightly change your usual lifestyle and give up some habits until complete recovery. Don't forget that following these rules will help you achieve positive results in just a few weeks. What is not recommended to do with bacterial vaginosis:

perform epilation of the bikini and perineum - these procedures are stressful for the body;
visit baths, saunas, lie for a long time in a hot bath or jacuzzi;
have sex - there is a risk of infecting your partner;
take antibacterial drugs on your own;
wear shapewear;
swim in open reservoirs and pools.

Treatment prognosis and possible unpleasant consequences

Therapy for gardnerellosis is an extremely complex and lengthy process. It often takes a lot of time to restore normal microflora, and some women quit treatment before even halfway through it. Remember that rehabilitation after such an illness proceeds much more slowly with the following ailments:

diabetes;
hypertension;
phlebeurysm.

In teenage girls and young people, gardnerellosis goes away with virtually no visible consequences if therapy is started in a timely manner. In older women and the elderly population, due to slow metabolic processes, rehabilitation lasts up to several years.

The disease is prone to recurrence. Cure does not guarantee that in a couple of months or years you will not have gardnerellosis again.

Compliance with the rules of personal hygiene plays a special role in restoring normal vaginal microflora. During treatment, it is extremely important that you have the opportunity to clean your perineum and change pads every few hours. I had the opportunity to participate in the treatment of a patient who was in a hot shop for twelve hours at work. She had practically no opportunity to wash herself, and in the hot season, even despite the ventilation, the temperature in the room was high, as a result of which the woman was constantly sweating. Excessive formation of sebum contributed to the appearance of itching and burning, and all the therapy for gardnerellosis was useless. Only after the patient managed to take a vacation for two months and go to a sanatorium did the treatment become effective. Sea water and warm air, combined with pharmaceuticals and hygiene rules, helped the woman forget about her illness.

What complications and negative consequences occur in patients with gardnerellosis:

problems with conception - altered microflora causes the death of sperm when they do not have time to reach the egg;
the formation of adhesions - growths of connective tissue in the pelvic cavity, which disrupt the normal attachment of the embryo in the uterus;
long-term infertility of various types;
inflammatory diseases of the pelvic organs: uterus, tubes, ovaries, bladder and urethra;
decreased immunity;
intrauterine infection of the fetus;
penetration of bacteria into the child’s body during childbirth.

Photo gallery: complications of the disease

Long-term jaundice indicates infection of the newborn Inflammation of the ovaries occurs when microflora penetrates from the vagina The adhesive process is characterized by the proliferation of connective tissue and disrupts the processes of conception and fetal development

How to protect yourself from developing the disease

Treatment of gardnerellosis requires the expenditure of a large amount of effort and money. That is why it is much easier to protect your body from the development of such a disease than to undergo a course of therapy. For this purpose, doctors have developed rules for individual prevention of the disease.

While studying in my fourth year of medical university, I had the opportunity to do an internship for several months in the gynecology department in Serbia. At this time, doctors were just conducting research on the topic of preventing bacterial vaginosis by taking lactobacilli and dairy products. For the study, a group of patients was selected who, throughout their lives during the winter season, had encountered Garnerellosis and its unpleasant consequences. More than half of them had problems with immunity (they often got sick or caught colds). Throughout the fall, doctors recommended that they take certain tablets with a high content of Latobacteria, and the women also added dairy products (cheeses, sour cream, sourdough) to their diet, which they consumed several times every day. As cold weather approached, doctors took the necessary tests from the patients - vaginal smears. In 95% of the studied patients, practically no gardnerella was observed in the material. Another 5% admitted that they did not always strictly follow doctors’ recommendations and drank alcoholic beverages. Thanks to this technique, most of the victims were able to forget about their disease forever.

Rules for individual prevention of gardnerellosis in women:

Garderellosis, or, as doctors also call it, bacterial vaginosis, is a mysterious disease. Some specialists, having discovered it, prescribe a bunch of antibiotics, others wave their hands condescendingly, saying it’s nothing to worry about.

And who to believe? What kind of infection is this? What danger does it pose? How to treat gardnerellosis, and in what cases should it be done? We will answer these and other questions in our review and video in this article.

Refers to infections transmitted primarily through sexual contact. When its causative agent, the anaerobic bacterium Gardnerella vaginalis, was first discovered, scientists classified the disease as a sexually transmitted disease.

However, upon closer examination, it turned out that this microorganism can be considered opportunistic: in small quantities it is found in the vaginal flora of almost every healthy woman, peacefully coexisting with beneficial lacto- and bifidobacteria. Gardnerella is activated only under certain conditions, causing such an unpleasant condition as bacterial vaginosis (otherwise known as dysbiotic changes in the vaginal microflora).

This is interesting. For a long time, gardnerellosis was considered an exclusively “female” disease. A little later it became clear that in rare cases a man can become infected with the microbe, but in representatives of the stronger half of humanity the infection is practically asymptomatic.

The development of the disease can be triggered by:

frequent change of sexual partners;
abuse of antiseptics (for example, constant washing with antibacterial soap, frequent douching, use of spermicides with disinfecting components for contraception);
pregnancy (read more);
long-term treatment with antibiotics.

Symptoms of Gardnerella infection are quite scarce. Among them:

vaginal discharge(their number may vary) white or yellowish;
spoiled fish.

Note! If the above symptoms are accompanied by itching, pain and burning in the area of the NPO, we can talk about the development of gardnerella vulvitis or vaginitis.

Diagnosis of the disease requires an integrated approach.

Standard medical instructions for examining a patient include:

Collection of complaints and medical history, during which the doctor will determine when the first complaints appeared and how the disease progresses.
Smear to determine the degree of purity.
Determination of vaginal pH (in case of dysbiosis, the vagina remains alkaline).
PCR diagnostics.
Bac sowing.

Important! The very fact of detecting gardnerella in the body is not a reason to start taking medication for gardnerella. The infection is diagnosed only if the number of pathogens exceeds 106-107 and is constantly increasing.

Principles of therapy

So, we have found that the main risk factors are changes in the normal microflora and decreased immunity. Therefore, the main treatment should be aimed at eliminating them.

Therapy with antibiotics effective against the causative agent of infection is indicated for:

the development of an inflammatory process of the vulva or vagina in women or the urethra in men;
during pregnancy in the 2-3 trimester (to exclude the possibility of infection of the fetus);
if general measures and lifestyle corrections are ineffective.

Note! Treatment should only be recommended to an expectant mother by an experienced specialist. Systemic agents are contraindicated. Preference is given to local dosage forms, and pregnant women are usually prescribed vaginal creams and suppositories for gardnerellosis.

Effective drugs

So, what drugs are used to treat gardnerellosis? In the sections below we will look at the most effective medications.

Metronidazole

Metronidazole is one of the popular drugs for the treatment of STDs in Russia. According to pharmacological consultation, it belongs to synthetic antimicrobial agents.

Has the following effects:

antibacterial;
protiprotozoal;
trichomonadocidal.

The product affects anaerobic microorganisms, destroying their DNA structure, disrupting reproduction processes and causing death.

Metronidazole for gardnerellosis can be prescribed either orally (orally) or topically. The tablets are usually taken twice a day for 5-10 days (depending on the severity of the infection).

Important! Metronidazole (like other antibiotics for gardnerellosis) is strictly forbidden to be used with any type of alcohol.

Local therapy involves the use of vaginal suppositories or gel 1-2 times a day. When the medication is administered exclusively into the vagina, the risk of side effects is significantly reduced.

The use of the drug is contraindicated:

in the 1st trimester of pregnancy;
when breastfeeding;
with individual intolerance;
with severe liver failure.

Clindamycin

Clindamycin is a drug from the lincosamide group. It has a bacteriostatic effect: it disrupts the synthesis of proteins in the microbial cell, thereby causing its death. Prescribed orally 150 mg every 6-8 hours. The course of treatment is determined individually.

The drug is not used in cases of hypersensitivity to its components, pregnancy, or impaired renal function.

Tinidazole is another popular antimicrobial and antiprotozoal agent. It has a high percentage of lipophilicity, which means it is easily absorbed from the gastrointestinal tract and spreads through the blood throughout the body, quickly creating a therapeutic concentration at the site of infection.

The doctor selects how to take Tinidazole for gardnerellosis individually. On average, the full course of therapy will take from 4 to 10 days.

The drug is contraindicated:

pregnant women;
mothers during lactation;
for diseases of the hematopoietic system;
with lesions of the nervous system of various origins.

Ornidazole

Ornidazole is a derivative of 5-nitroimidazole. Its pharmacological effect is also based on interaction with anaerobic DNA and its destruction.

It is a less popular medicine to combat the disease, but very effective. Already 2 hours after the first dose, its required concentration is reached in the body.

Ornidazole for gardnerellosis is taken according to an individual regimen. The “working” dosage of the drug for adults is 2.5 g, divided into several doses.

The product has standard contraindications:

individual intolerance;
first weeks of pregnancy;
lactation.

Note! Ornidazole is an active substance that is part of the drug of the same name, as well as many others. Among them are Ornisid, Avrazor, Gairo, Dazolik, Tiberal: for gardnerellosis they have almost the same effectiveness.

Vilprafen tablets (active component - Josamycin) are among the newest representatives of macrolides. Today, this pharmacological group is one of the promising areas in the drug treatment of genitourinary system infections.

Anaerobes exhibit particularly high sensitivity to the drug, so experts are increasingly prescribing Vilprafen for gardnerellosis.

To obtain the desired therapeutic effect, you must take at least three tablets of the medicine per day (the doctor will determine the exact dosage individually based on test results). The advantage of Vilprafen is that the drug can be used during pregnancy (under the supervision of a specialist) and lactation.

Contraindications to its use are:

hypersensitivity to representatives of the pharmacological group;
severe dysfunction of internal organs (liver, kidneys).

Azithromycin is another popular macrolide used to treat genitourinary diseases. However, for bacterial vaginosis, the medicine is prescribed with caution, since it destroys the normal vaginal flora with the same success and can aggravate the problem of dysbiosis.

If Azithromycin is still prescribed for gardnerellosis, it is not recommended to exceed the standard five-day course of treatment. In addition, after finishing taking the drug, you will have to restore the number of bifidobacteria and lactobacilli.

during pregnancy;
during breastfeeding;
for decompensated liver and kidney diseases;
for disorders of the blood coagulation system.

Macmiror is a drug from the nitrofuran group with the active ingredient nifuratel. It has complex antimicrobial, antiprotozoal and antifungal effects.

Due to its wide spectrum of activity and low toxicity, it is used to treat many infections, including the female genital area.

Macmiror is prescribed for gardnerellosis in the form of tablets according to an individually selected regimen (usually at least 3 times a day). The course of therapy is 7-14 days. The medicine can be used during pregnancy, but only if the expected effect of treatment outweighs the possible risk to the fetus.

Local treatment

The effect of systemic antibiotics can be enhanced using local dosage forms.

Most often, experts prefer the drug Hexicon for gardnerellosis. The active component in its composition is chlorhexidine. This antiseptic is destructive to many pathogenic bacteria, but does not cause a significant decrease in the number of normal vaginal microflora.

As a rule, the effect of treatment is noticeable within a few days. Another positive point is the possibility of use during pregnancy.

Terzhinan is a popular drug based on neomycin sulfate, available in the form of vaginal suppositories. Effective both in combination with oral antibiotics and individually. In the absence of complications, Terzhinan for gardnerellosis is prescribed in a ten-day course.

Polygynax for gardnerellosis is prescribed in cases where Gardnerella vaginalis is “adjacent” to other pathogenic microorganisms (mycoplasmas, chlamydia). However, in case of combined infections, systemic antibiotic therapy cannot be avoided. Clotrimazole for gardnerellosis is recommended in situations where anaerobic infection is combined with candidiasis (thrush).

Douching for gardnerellosis is of questionable effectiveness and is not recommended by official sources. However, some doctors prescribe this procedure to their patients. The drugs of choice are the popular antiseptics Chlorhexidine and hydrogen peroxide: for gardnerellosis, they reduce the concentration of harmful anaerobes.

Summing up

So, how do doctors treat gardnerellosis today?

The general treatment regimen can be described by the following algorithm:

Elimination of excessive amounts of gardnerella in the genital tract. First-line antibiotics - Metronidazole and Clindamycin (during pregnancy - Ampicillin and Metronidazole). Both oral and local use are possible.
Restoration of normal vaginal microflora. The most commonly used are vaginal suppositories containing beneficial lactobacilli (Lactonorm, Acylact). In addition, a diet excluding spicy and fatty foods, alcohol and sweets is recommended. It is advisable to eat a large amount of fermented milk products (kefir, yogurt).
According to indications - taking immunomodulators (adjusting echinacea, Immunal, Immunorm).

Table: Popular antibiotics for the treatment of gardnerella infection:

Prevention methods

If we are talking about the prevention of gardnerellosis, it would not be amiss to talk about small changes in diet. First you need to exclude alcohol, spices, fatty, fried, sour, spicy and pickled foods.

Enrich your diet with dairy and fermented milk products, vegetables. Prophylactic use of prebiotics will be necessary to avoid intestinal dysbiosis. Linex or bifidumbacterin are excellent for these purposes.

Women should stop douching and using birth control pills that contain 9-nonoxynol. In addition, an important aspect is regular adherence to general and intimate hygiene.

Questions for the doctor

Selection of dosage

Girl, I'm 22 years old. Two months ago, I began to experience vaginal discharge with an unpleasant odor. I was examined and gardnerellosis was discovered. The gynecologist prescribed Amoxiclav for 5 days and Pimafucin suppositories: is this an effective treatment for gardnerellosis? Tell me what dosage of antibiotic I should buy, 250 or 500, for some reason the doctor didn’t specify.

Hello! Amoxiclav is not the drug of choice for gardnerellosis. For this disease, this medicine can only be prescribed to pregnant women, but only because there is nothing else to treat the infection (many antibiotics are contraindicated for expectant mothers). The standard treatment regimen for the disease involves the administration of Metronidazole or Clindamycin.

STD treatment course for sexual partners

Hello! I recently had a urethral smear and found gardnerella and ureaplasma. A few days before, I had unprotected sex with a girl (virgin). After this, she began to experience symptoms similar to cystitis (burning, pain when urinating). Now I am receiving treatment prescribed by the doctor - Ofloxacin, Metronidazole, Flucostat. Is it suitable for a girl?

Good day! This treatment can be taken by both partners. Also, upon completion, you can take probiotics and an immunomodulator. After antibiotic therapy, you and your partner definitely need to undergo follow-up tests. During treatment, maintain sexual rest.

Controversial issue

Greetings. Now I am being treated for gardnerellosis and the question arose: how to treat a partner with gardnerellosis and is it necessary at all? My partner has no signs of illness.

Hello. In some cases, men may have no symptoms, then it would be logical to assume that he is only a carrier of the infection. The need for treatment in men in the absence of symptoms is still a controversial issue, since this does not exclude the recurrence of the disease in women.

This is interesting. For a long time, gardnerellosis was considered an exclusively “female” disease. A little later it became clear that in rare cases a man can become infected with the microbe, but in representatives of the stronger half of humanity the infection is practically asymptomatic.

The development of the disease can be triggered by:

frequent change of sexual partners;
abuse of antiseptics (for example, constant washing with antibacterial soap, frequent douching, use of spermicides with disinfecting components for contraception);
pregnancy (read more);
long-term treatment with antibiotics.

Symptoms of Gardnerella infection are quite scarce. Among them:

vaginal discharge(their number may vary) white or yellowish;
spoiled fish.

Note! If the above symptoms are accompanied by itching, pain and burning in the area of the NPO, we can talk about the development of gardnerella vulvitis or vaginitis.

Diagnosis of the disease requires an integrated approach.

Standard medical instructions for examining a patient include:

Collection of complaints and medical history, during which the doctor will determine when the first complaints appeared and how the disease progresses.
Smear to determine the degree of purity.
Determination of vaginal pH (in case of dysbiosis, the vagina remains alkaline).
PCR diagnostics.
Bac sowing.

Important! The very fact of detecting gardnerella in the body is not a reason to start taking medication for gardnerella. The infection is diagnosed only if the number of pathogens exceeds 106-107 and is constantly increasing.

Principles of therapy

So, we have found that the main risk factors are changes in the normal microflora and decreased immunity. Therefore, the main treatment should be aimed at eliminating them.

Therapy with antibiotics effective against the causative agent of infection is indicated for:

the development of an inflammatory process of the vulva or vagina in women or the urethra in men;
during pregnancy in the 2-3 trimester (to exclude the possibility of infection of the fetus);
if general measures and lifestyle corrections are ineffective.

Note! Treatment should only be recommended to an expectant mother by an experienced specialist. Systemic agents are contraindicated. Preference is given to local dosage forms, and pregnant women are usually prescribed vaginal creams and suppositories for gardnerellosis.

Effective drugs

So, what drugs are used to treat gardnerellosis? In the sections below we will look at the most effective medications.

Metronidazole

Metronidazole is one of the popular drugs for the treatment of STDs in Russia. According to pharmacological consultation, it belongs to synthetic antimicrobial agents.

Has the following effects:

antibacterial;
protiprotozoal;
trichomonadocidal.

The product affects anaerobic microorganisms, destroying their DNA structure, disrupting reproduction processes and causing death.

Metronidazole for gardnerellosis can be prescribed either orally (orally) or topically. The tablets are usually taken twice a day for 5-10 days (depending on the severity of the infection).

Important! Metronidazole (like other antibiotics for gardnerellosis) is strictly forbidden to be used with any type of alcohol.

Local therapy involves the use of vaginal suppositories or gel 1-2 times a day. When the medication is administered exclusively into the vagina, the risk of side effects is significantly reduced.

The use of the drug is contraindicated:

in the 1st trimester of pregnancy;
when breastfeeding;
with individual intolerance;
with severe liver failure.

Clindamycin

The drug is not used in cases of hypersensitivity to its components, pregnancy, or impaired renal function.

The doctor selects how to take Tinidazole for gardnerellosis individually. On average, the full course of therapy will take from 4 to 10 days.

The drug is contraindicated:

pregnant women;
mothers during lactation;
for diseases of the hematopoietic system;
with lesions of the nervous system of various origins.

Ornidazole

Ornidazole is a derivative of 5-nitroimidazole. Its pharmacological effect is also based on interaction with anaerobic DNA and its destruction.

It is a less popular medicine to combat the disease, but very effective. Already 2 hours after the first dose, its required concentration is reached in the body.

Ornidazole for gardnerellosis is taken according to an individual regimen. The “working” dosage of the drug for adults is 2.5 g, divided into several doses.

The product has standard contraindications:

individual intolerance;
first weeks of pregnancy;
lactation.

Note! Ornidazole is an active substance that is part of the drug of the same name, as well as many others. Among them are Ornisid, Avrazor, Gairo, Dazolik, Tiberal: for gardnerellosis they have almost the same effectiveness.

Anaerobes exhibit particularly high sensitivity to the drug, so experts are increasingly prescribing Vilprafen for gardnerellosis.

Contraindications to its use are:

hypersensitivity to representatives of the pharmacological group;
severe dysfunction of internal organs (liver, kidneys).

during pregnancy;
during breastfeeding;
for decompensated liver and kidney diseases;
for disorders of the blood coagulation system.

Macmiror is a drug from the nitrofuran group with the active ingredient nifuratel. It has complex antimicrobial, antiprotozoal and antifungal effects.

Due to its wide spectrum of activity and low toxicity, it is used to treat many infections, including the female genital area.

Local treatment

The effect of systemic antibiotics can be enhanced using local dosage forms.

As a rule, the effect of treatment is noticeable within a few days. Another positive point is the possibility of use during pregnancy.

Summing up

So, how do doctors treat gardnerellosis today?

The general treatment regimen can be described by the following algorithm:

Elimination of excessive amounts of gardnerella in the genital tract. First-line antibiotics - Metronidazole and Clindamycin (during pregnancy - Ampicillin and Metronidazole). Both oral and local use are possible.
Restoration of normal vaginal microflora. The most commonly used are vaginal suppositories containing beneficial lactobacilli (Lactonorm, Acylact). In addition, a diet excluding spicy and fatty foods, alcohol and sweets is recommended. It is advisable to eat a large amount of fermented milk products (kefir, yogurt).
According to indications - taking immunomodulators (adjusting echinacea, Immunal, Immunorm).

Table: Popular antibiotics for the treatment of gardnerella infection:

Prevention methods

Women should stop douching and using birth control pills that contain 9-nonoxynol. In addition, an important aspect is regular adherence to general and intimate hygiene.

Questions for the doctor

Selection of dosage

Girl, I'm 22 years old. Two months ago, I began to experience vaginal discharge with an unpleasant odor. I was examined and gardnerellosis was discovered. The gynecologist prescribed Amoxiclav for 5 days and Pimafucin suppositories: is this an effective treatment for gardnerellosis? Tell me what dosage of antibiotic I should buy, 250 or 500, for some reason the doctor didn’t specify.

STD treatment course for sexual partners

Hello! I recently had a urethral smear and found gardnerella and ureaplasma. A few days before, I had unprotected sex with a girl (virgin). After this, she began to experience symptoms similar to cystitis (burning, pain when urinating). Now I am receiving treatment prescribed by the doctor - Ofloxacin, Metronidazole, Flucostat. Is it suitable for a girl?

Controversial issue

Greetings. Now I am being treated for gardnerellosis and the question arose: how to treat a partner with gardnerellosis and is it necessary at all? My partner has no signs of illness.

Gardnerellosis is a disease of the urogenital tract in women. Its causative agents are anaerobic bacteria - Gardnerella vaginalis. Their development in the vagina is activated under the influence of external or internal unfavorable factors on the woman’s body.

The inflammatory process develops due to the fact that gardnerella, in the process of its life activity, secretes alkaline products that kill the normal inhabitants of the vaginal microbiocenosis, i.e. lactobacilli.

The main symptoms of gardnerellosis are a burning sensation in the vagina and gray-white discharge, which has a characteristic smell of rotten fish.

The treatment of gardnerellosis, or, as it is also called, bacterial vaginosis, should be approached very seriously, since this disorder of the microflora can lead not only to inflammatory processes, but even to infertility in women.

Basics of therapy

There are two stages to treating bacterial vaginosis. It is worth noting that the second stage without the first will be absolutely ineffective.

Thus, the first stage includes the use of antibacterial and antiseptic drugs, which are aimed at destroying the causative agent of bacterial vaginosis, i.e. gardnerell.

The second stage involves “populating” the vagina with normal microflora, i.e. lactobacilli. For these purposes, suppositories or vaginal tablets containing a live lyophilized culture of lactobacilli are used.

One of the most popular forms of drugs for treating the disease caused by Gardnerella vaginalis are suppositories.

Drugs in this dosage form contain the same active ingredients as tablets. However, the advantage is that their effect is milder, since it is not aimed at the entire body (as is the case with the use of tablets) - suppositories have an exclusively local effect.

It is recommended to treat vaginal dysbiosis in pregnant women using suppositories and vaginal tablets.

Treatment of gardnerellosis (for example, using Macmiror, Terzhinan and other local drugs) generally lasts at least 6-8 days.

Brief description of candles:

"McMirror"

This remedy is very popular today in the treatment of bacterial vaginosis. "Makmiror" contains nifuratel and nystatin, which makes it effective for vaginal dysbiosis.

Nifuratel is a broad-spectrum antiseptic that acts not only on Gardnerella vaginalis, but also on other pathogenic and opportunistic microflora that cause inflammatory processes in the reproductive system of women.

Nystatin, which is also one of the active ingredients of Macmiror, has an antifungal effect, which is extremely important for the treatment of disorders of the vaginal microbiocenosis, since yeast-like fungi of the genus Candida often “go hand in hand” with bacterial vaginosis.

"Terzhinan"

The active ingredients of this drug are neomycin sulfate, ternidazole and nystatin. At the same time, it is ternidazole that has an active effect on gardnerella, and nystatin is aimed at destroying fungal microflora. Neomycin sulfate acts on pyogenic bacteria, which can also live in the vagina, causing dysbacteriosis of its microflora.

As an anti-gardnerella therapy, Terzhinan is inserted into the vagina only once a day before bedtime for 10 days. It should be remembered that its use is contraindicated in the first trimester of pregnancy.

Suppositories with metronidazole

This antiseptic is also actively used to treat anaerobic infection caused by gardnerella. Drugs that contain metronidazole include “Metronidazole-suppositories”, “Metrovit”, “Metrovagin”. Note that these drugs are completely incompatible with alcohol consumption.

To completely cure gardnerellosis, it is recommended to use vitamin therapy, immunocorrection and physiotherapy. It is also necessary to abstain from sexual intercourse during the course and lead a calm lifestyle, since not only women’s health, but also the ability to bear children will depend on the successful outcome of treatment of this disease.