The best treatment for chlamydia. Treatment regimens, physiotherapy and diagnosis of chlamydia in women. Chlamydia. Chlamydia treatment

There are billions of bacteria in the world, but one of the most unpleasant and often dangerous is chlamydia. The diseases caused by it are collectively called chlamydia, most often they can be infected sexually. Today it is one of the most common reasons for visiting a venereologist. More than 50% of men and 30% to 60% of women have had or have chlamydia.

A rather serious and long-term treatment regimen for chlamydia in men. Preparations prescribed to the fair sex can be supplemented with vaginal suppositories. To select an effective treatment regimen for chlamydia in men and women, it is necessary to know the nature of the disease.

What is this bacterium?

Chlamydia bacteria infect the mucous membranes, and not only of humans, but also of animals. Chlamydial infections vary from ornithosis to trachoma, but most often they are diseases of the genitourinary system. This is due to the fact that the family of chlamydial bacteria has various "relatives":

Chlamydia pecorum and Chlamydia psittaci are bacteria that live with birds. A person can also become infected after close contact with them, hence eye diseases - from conjunctivitis to psittacosis.

Chlamydia pnuemoniae with a telling name affects the human respiratory system. Hence, diseases such as pneumonia, tonsillitis and pharyngitis, upper respiratory tract infections caused by viral infection.
- the most "harmful" type of virus, which has 15 subspecies, one of which is the subject of the article. The virus is transferred from the body to the body sexually, often accompanied by other infections (mycoplasmosis, papillomas, bacterial vaginosis, etc.). Treatment of chlamydia in men (drugs, scheme) is prescribed by a doctor to successfully rid the body of bacteria.

What else is dangerous chlamydia?

The bacterium spreads throughout the body, preferring mucous membranes. Chlamydia can cause diseases not only of the eyes, genitourinary system or pharynx. They hit and cardiovascular system. The relationship between chlamydia bacteria and ischemic disease hearts. According to some doctors, chlamydia bacteria are also the root cause of arthritis.

The most common are diseases that develop after infection of the genital organs. They are especially dangerous during pregnancy and childbirth. Chlamydia can contribute to miscarriages, termination of pregnancy, infection of the child both inside the womb and at birth. The treatment regimen for expectant mothers is not the same as the treatment regimen for chlamydia in men. Drugs for the treatment of the disease are selected individually.

The most common diseases caused by this bacterium are called urethritis, cystitis, erosion, prostatitis, cervicitis and endometritis. What is especially dangerous, the disease often occurs against the background of other infections, often in a chronic form. Chlamydia live in our body together with gonococcus and Trichomonas.

There is no vaccine against chlamydia because the body cannot develop immunity to it. There is also no natural immunity. Therefore, the treatment of chlamydia in men is so important. Drugs, the regimen of which will significantly reduce the risk of complications, will be listed below.

How to identify the disease

The incubation period after infection and before the onset of the first symptoms is from 7 to 21 days.

Most often it is manifested by vitreous discharge, scanty secretions of a mucous or purulent nature, painful urination, itching of the genital organs, prolonged aching or pulling pains in the lower abdomen in women and in the scrotum in men, a slight fever and general malaise. Some of the symptoms may be absent, and after a while they disappear altogether. There have been cases of asymptomatic course of the disease. Chlamydia manifests differently in men and women; symptoms, treatment is also individual.

Often, an infected person, without taking any measures, after the disappearance of unpleasant symptoms, forgets about the problem. But at the same time, the disease remains and periodically reminds of itself.

The virus quickly overcomes the immune barriers of our body, the disease becomes protracted and goes into a chronic stage.

Get tested for chlamydia

The asymptomatic course of the disease or its lull makes it very difficult to treat other, as it seems to us, unrelated diseases. For example, pneumonia or infertility are treated with completely different drugs that have no effect on chlamydia, which does not bring the desired effect. Therefore, it is necessary to take tests for the detection of Chlamydia bacteria.

Modern equipment makes it possible various methods diagnostics: RIF, PCR, ELISA and others. A normal smear, unfortunately, most often does not detect a bacterium, since it is too small.

For the timely detection and fight against chlamydia, you need to contact a specialist. The treatment regimen for chlamydia in men, the drugs prescribed by the doctor, depend on the stage of the disease and the sensitivity of the bacteria. Self-therapy is highly discouraged.

Chlamydia. Treatment (drugs-antibiotics)

Chlamydia are very complex and insidious bacteria that also have the properties of viruses. The usual treatment for a bacterial or viral disease will not work. An integrated approach with antibiotics, multivitamins and immunomodulators is needed. It can not be called short-term treatment of chlamydia in men. The drugs used for therapy should be chosen by the doctor. The pharmacist in the pharmacy will not be able to select them correctly.

A very extensive and complex treatment regimen for chlamydia in men. Drugs prescribed to fight the disease, for the most part, are not cheap. More than one course may be required. A healthy lifestyle and diet will contribute to a speedy recovery. It is also necessary to refrain from sexual activity during the course of treatment. And if the sick person has one permanent sexual partner, then the need to take tests for both is obvious. The scheme and drugs for the treatment of chlamydia in men and women can be prescribed differently.

After a full course of treatment, it is necessary to take tests to exclude the risk of infection again. The analysis is given first 21 days after the end of treatment, and then two months later.

The bacterium chlamydia is very tenacious and can go into a dormant stage in the body. Urogenital chlamydia can recur after a few years, for example. This is the result of improper treatment.

Where does therapy start?

Before the first visit to the doctor, it is necessary to stop taking all drugs if you have previously tried to treat chlamydia yourself. Toilet spend in the evening. It is not necessary to wash in the morning, it is also advisable not to go to the toilet for two to three hours before taking it.

For the treatment of chlamydia, first take the usual bacteriological smear: in women - from the vagina, in men - from the urethra. A smear will also help determine the presence of bacteria and viruses associated with chlamydia.

A blood test is possible, which will show the presence / absence of antibodies to the bacteria. If they are present, then you are infected. This analysis is not always informative and accurate for a number of reasons.

PCR analysis will show with the greatest accuracy the presence of bacteria. For its implementation, discharge from the genital organs is necessary. On the basis of this material, crops are also sown. The bacterium is propagated to more. Conducting various studies, determine its type and, accordingly, treatment.

Treatment regimen

There is chlamydia in men and women, the treatment regimen is different. Often, women add vaginal suppositories.

Antibiotics from the macrolide family, tetracyclines or penicillins are prescribed. If there are contraindications to these drugs, then other antibiotics may be prescribed at the discretion of the doctor. Doses and method of administration are prescribed individually by the attending physician.
Antifungal agents may be prescribed.
required to enhance the effect and immune response. Most often in the form of candles (for example, "Viferon").
The doctor may prescribe vitamins to strengthen the immune system.
Mandatory diet and proper lifestyle, alcohol must be excluded.
Retesting after a course of treatment.

Chronic chlamydia. Symptoms, treatment regimens

Often, the disease proceeds in a latent and form, and by the time you go to the doctor, it can go into a chronic stage. In this case, the treatment of the disease becomes more complicated. When the disease flows into the next form, treatment of chronic chlamydia in men is mandatory. Treatment is possible only during the period of exacerbation. If you try to eliminate the disease during the calm period, then the bacterium will simply get used to antibiotics, and the effect of taking them will be extremely negative. In this case, the chronic form of the disease in most cases is accompanied by others (thrush, gonorrhea, trichomoniasis and others).

Treatment (drugs, scheme - we are considering all this) is as follows:

Mandatory testing to determine the type of bacteria and its sensitivity to antibiotics.
Prescribing antibiotics at a higher dose. It is possible to take several types, but it is preferable to choose one group to which all bacteria in the body are sensitive.
To achieve the best effect from course to course, the preparations are changed to avoid the bacteria becoming addicted to a particular remedy.
Detection of all types of chlamydia and treatment of other foci of infection. For example, when eliminating urogenital chlamydia, bacteria may remain in the body, disease-causing lungs (Chlamydis pneumonia).
Appointment of immunomodulators.
Points 4,5,6 from the previous section.

Medical treatment. Antibiotics

The most effective antibiotics for the treatment of chlamydia are drugs that penetrate into the cells and accumulate in them. The probability of bacterial infection will be highest in three groups of drugs:

Tetracyclines.
Macrolides.
Fluoroquinolones.

To maintain immunity, it is necessary to combine a course of antibiotics with immunomodulating agents.

Observe the time of taking medications (the same, at the same intervals).
Continue the course of treatment until the end, even after the condition improves (symptoms may disappear almost immediately).
Treat both partners at the same time.
Do not have sexual intercourse during the entire course of treatment.
Surrender everything necessary tests before and after treatment.

Rating of antibiotics for the treatment of urogenital chlamydia

"Doxycycline" is one of the most popular antibacterial drugs. Recognized by doctors as one of the best in this field. The main disadvantage is a large number of side effects that occur quite often. Indigestion and thrush are increasingly forced to look for alternatives.

"Azithromycin" conditionally occupies the second line of the rating among antibiotics prescribed for chlamydia. When taking it, it is necessary to carefully monitor the emerging side effects. Be sure to pass a test for the sensitivity of bacteria to this drug before the appointment.

List of less popular remedies

In no case should you be guided by advice from the Internet or buy what your friends were treated with. Antibiotics must be prescribed by a doctor.

The most commonly prescribed drugs by specialists:

"Klacid" is a highly effective treatment (with a course of 3 days to 2 weeks).
"Ceftriaxone" is a third-generation antibiotic with a wide spectrum of action.
"Josamycin" and "Macropen" - macrolide drugs of a new generation, have the least number of side effects.
"Sumamed" - in the background high efficiency the fewest side effects.
Rulid, Klabaks, Hemomycin, Clarithromycin are semi-synthetic macrolide antibacterial drugs.
"Rovamycin", "Unidox Solutab" - antibiotics of the tetracycline group.
"Vilprafen" and "Amoxiclav" - are prescribed for pelvic infections.
"Erythromycin" is a highly effective remedy for the treatment of chlamydia.

The effectiveness of antibiotics is very individual, with the wrong appointment (often self-administered), the reception can significantly worsen a person's condition.

Traditional medicine in the fight against chlamydia

With an abundance of medical supplies and all the availability of therapy in hospital settings, some prefer to treat with folk remedies. Various teas, tinctures and decoctions sometimes give a good result:

For the prevention of chlamydia and treatment in the early stages, you can brew a collection of birch leaves and horsetail grass. One tablespoon of a mixture of herbs and leaves is poured with 2 cups of boiling water and insisted for about half an hour. Drink three times a day for half a glass.
and juniper in equal parts are mixed and a tablespoon is brewed in a glass of boiling water. The infused broth is drunk one spoonful three times a day.
also in folk medicine use elsgoltia. Decoctions and tinctures with this herb have a bactericidal effect.
You can combine teas and decoctions from viburnum, rose hips, willow leaves and bark, sea buckthorn, nettle grass, chamomile, thyme, etc.

List folk remedies and the recipes are huge. The main advice is that it is necessary to consult a doctor in a timely manner if the situation worsens and in no case let the disease take its course.

Prevention

As you know, prevention is easier than cure. The first rule in the prevention of chlamydia is hygiene of sexual life.

A regular sexual partner and the absence of casual unprotected sex can protect you from infection.

The use of barrier contraceptives (condoms) and timely access to a doctor will help, if not avoid, then significantly speed up the treatment process.

It should be noted that there are cases when even specialists may not recognize the treatment, drugs - we discussed all this above. Listen to your body and do not delay your visit to the doctor!

Genitourinary chlamydia is one of the most common sexually transmitted infections. About 80 million new cases of this disease are registered annually worldwide.

In Russia, official records of cases of infection have been maintained since 1993. It is noteworthy that already in 1994, urogenital chlamydia was included in the group of widespread infections with sexual transmission.

According to official data from the Federal State Statistics Service, in the period from 1995 to 2005, the incidence increased by more than 40% and amounted to 95.6 people per 100,000 people. Since 2005, the prevalence of the disease has been slightly decreasing, by 2014 it was 46.1 per 100 thousand of the population (Rosstat data).

Genitourinary infection caused by chlamydia trachomatis is equally widespread among men and women and occurs about 3 times more often than gonorrhea and 7.6 times more often than syphilis (Davydov A.I., Lebedev V.A., 2002).

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1. Causes of widespread chlamydial infection

Among the reasons that led to the widespread chlamydial infection throughout the world, we can distinguish:

1 An increase in the number of persistent forms of chlamydia resistant to antibiotics resulting from uncontrolled self-medication;
2 Lack of health education of the population, an increase in the number of lonely people;
3 Early average age of intimacy;
4 Low level of public awareness about sexually transmitted infections;
5 Long-term asymptomatic course of chlamydia, late onset of disease symptoms along with early development of complications;
6 Large percentage of asymptomatic infection among men;
7 Lack of natural immunity to chlamydia, unstable acquired immunity;
8 Violation of the body's immune reactivity as a result of prolonged persistence of the pathogen.

Separately, it is necessary to highlight the frequent lack of complex treatment of the disease in sexual partners, which leads to constant reinfection and a wider spread of bacteria.

Even asymptomatic carriage of chlamydia does not at all reduce its contagiousness and requires immediate treatment.

2. Regulatory documents used in the treatment of chlamydia

Chlamydia belongs to a group of infections that affect many organs and tissues, so it can be considered as a systemic disease. This approach allows you to competently approach etiotropic (aimed at the pathogen) and pathogenetic (aimed at correcting the violations) therapy.

The treatment of chlamydia is a rather difficult task, which can only be done by competent specialists and medical institutions equipped with a solid laboratory. The task of therapy is not only the removal of the pathogen from the body, but also the elimination of all disorders caused by the vital activity of chlamydia trachomatis.

Currently, all the doctor's actions in the treatment of chlamydia are clearly algorithmized, which makes it possible to avoid mistakes in the choice of drugs and increase the effectiveness of measures.

In most countries of the world, the treatment of urogenital chlamydia is regulated by special regulations issued by public health authorities.

Most often, WHO recommendations are used in the development of national standards, European Union or the USA, since the guides they offer are based on a large number of clinical trials and have a sufficient evidence base.

To provide specialized care to patients with urogenital chlamydia, Russia has developed its own standard, which is based on:

1 WHO recommendations;
2 CDC recommendations (USA);
3 European recommendations (AGUM, MSSVD)

3. Problems of the effectiveness of drug therapy

Despite the developed and approved treatment regimens for chlamydia, long-term treatment often does not lead to complete recovery. After completing the course, the frequency of recurrence of infection is quite high (from 10% to 50%).

Chlamydia have a unique cycle of intracellular development, in which two completely different forms pathogen:

1 Elementary bodies are forms adapted to existence outside the cell and sufficiently resistant to aggressive factors environment which makes them insensitive to the effects of antibiotics.
2 Reticular bodies - an intracellular form with a diameter of 0.6 to 1.2 microns, metabolically active and living solely at the expense of the host organism. This form does not survive outside the cell.

With the wrong and irrational choice of antibacterial drugs, chlamydia can go into the L-form. This situation occurs, in particular, when taking antibiotics from the penicillin group, as well as with fractional and intermittent treatment.

4. Antibiotic resistance

Today, a large number of antibiotics with a proven anti-chlamydial effect are presented on the pharmaceutical market. The choice of one or another antibacterial drug is made in accordance with international and Russian standards of therapy and current treatment regimens.

However, the treatment of patients with urogenital chlamydia is complex and often ineffective. Even with the step-by-step observance of the proposed scheme, the elimination of the pathogen from the body is not always guaranteed.

An important role in the formation of this phenomenon is played by the gradual emergence of resistance to antibiotics in chlamydia. The first reports of resistance of the pathogen to antibacterial drugs began to appear in 1980, in particular, isolated cases of chlamydia resistance to tetracycline, erythromycin, clindamycin or doxycycline were recorded.

Later, such cases began to be recorded more and more often, and at the moment there is evidence of multiple resistance of chlamydia trachomatis to the three main groups of antibacterial drugs.

The formation of resistance to chlamydia occurs in two directions. The first is a mutation in the genes encoding the production of certain enzymes on the surface of the bacterial cell, as a result of which the activity of the drugs is lost.

The second mechanism is associated with a decrease in the permeability of the outer cell membrane of chlamydia, resulting in slower penetration medicinal product in a cell. Despite the described mechanisms, resistance to macrolides has not yet been fully studied.

Another factor influencing the final result of therapy is the ability of chlamydia to persistence. Persistence is a long-term association of chlamydia in body tissues.

In this case, the pathogen lives inside the infected cell, but the transformation of reticular bodies into elementary bodies is temporarily blocked. The ability to restore an adequate development cycle is realized when favorable conditions occur.

This means that under unfavorable conditions, chlamydia stop their division, slightly change their antigenic properties and enter into a state of complete "balance" with the infected organism. During this period, chlamydia is metabolically inactive.

5. Etiotropic therapy of urogenital chlamydia

Therapy for urogenital chlamydia for each patient is selected individually.

1 The effectiveness of the drug should be at least 95%;
2 The drug must be affordable;
3 The drug should be well tolerated and have low toxicity;
4 Possibility of single oral administration is an advantage;
5 The development of pathogen resistance to this particular drug should be slow;
6 The drug should be safe for use during pregnancy and lactation.

5.1. Groups of antibacterial agents

According to the level / ability to penetrate into the cell, all antibiotics can be divided into three groups:

1 Poorly penetrating: penicillins, cephalosporins, nitroimidazoles;
2 Moderate: tetracyclines, aminoglycosides, fluoroquinolones;
3 Penetrating cells: macrolides.

Based on the foregoing, at the moment the main drugs for the treatment of urogenital chlamydia are antibiotics of the group of tetracyclines, macrolides and fluoroquinolones.

Tetracyclines are one of the first antibacterial drugs discovered in the middle of the last century. They interact with the 30S subunit of ribosomes on the surface of the bacterial cell, which leads to disruption of the protein synthesis process.

Macrolides are products of the natural metabolism of actinomycetes; their structure is based on a lactone macrocyclic ring. The very first representative of this group, erythromycin, was first isolated in the 1950s. Macrolides inhibit the process of protein synthesis by binding to the 50S subunits of ribosomes on the surface of bacteria.

The group under consideration includes more than a dozen different drugs; in the treatment of chlamydia in pregnant women and children, these antibiotics are considered first of all. Even a single oral dose of azithromycin at a dose of 1 gram is quite effective in uncomplicated infections.

A special place in the national recommendations is occupied by antibiotics of the fluoroquinolone group - highly effective means wide spectrum of antimicrobial activity. Their features are a low percentage of binding to plasma proteins, a wide volume of distribution throughout the body, a long half-life and high bioavailability. Fluoroquinolones are equally highly effective both parenterally and orally.

Their mechanism of action is based on inhibition of bacterial DNA synthesis. For the treatment of chlamydia, ofloxacin and levofloxacin are recommended by European and US guidelines.

The duration of treatment for chlamydia of the upper genitourinary system (pelvic organs, extragenital localization) is determined by the severity of clinical symptoms, the results of laboratory tests and ranges from 14 to 21 days, depending on the severity of the infection.

Currently, a new group of antibacterial agents, ketolides, is expected to be introduced to the pharmaceutical market, which will increase the effectiveness of antimicrobial therapy.

Chlamydial infection can affect both the lower and upper parts of the genitourinary system. Treatment for chlamydia may vary depending on the location of the infection.

Russian protocols and European schemes for the treatment of chlamydia of the lower genitourinary tract suggest the use of (one of the indicated drugs):

Macrolides:
Azithromycin (Sumamed, Zitrolid, Hemomycin) 1.0 g once; Josamycin (Vilprafen) 500 mcg 3 r / s - course 1 week.
Tetracyclines:
Doxycycline (Unidox Solutab) 200 mg first dose, then 100 mg 2 r / s - course 1 week.

Alternative treatment regimens include (one of the following drugs):

Macrolides:
Erythromycin 500 mg 4 r / s - course 1 week; roxithromycin 150 mg 2 r / s - course 1 week; clarithromycin 250 mg 2 r / s - course 1 week.
2 Fluoroquinolones: ofloxacin 400 mg 2 times a day - course 1 week.

Treatment with antibacterial agents should interrupt at least 4-6 cycles of chlamydia development, one of which lasts about 72 hours.

Treatment of chlamydia with lesions of the upper genitourinary system is also regulated, the duration of therapy, as a rule, is somewhat higher than with uncomplicated infection.

The total duration of the course is determined by the severity of the clinical picture, the results of laboratory tests and is 14-21 days, depending on the severity of the infection. The drugs of choice are:

1 Doxycycline (Unidox Solutab) 100 mg 2 times a day;
2 Josamycin (Vilprafen) 500 mg 3 times a day.

Alternative antimicrobials include:

1 Levofloxacin 500 mg once daily;
2 Ofloxacin 400 mg bid.

In the vast majority of cases, the presented schemes of drug etiotropic therapy are supplemented with symptomatic and pathogenetic agents - immunomodulators, anti-inflammatory drugs, enzymes, antispasmodics, circulatory stimulants. Not all of them have a sufficient evidence base.

5.3. Tactics of conducting pregnant women

Infection with chlamydia during pregnancy can lead to the following consequences:

1 preterm birth;
2 Spontaneous abortion, miscarriage;
3 Frozen pregnancy;
4 Intrauterine infection of the fetus;
5 Pneumonia and conjunctivitis of the newborn.

The choice of drugs for the treatment of chlamydia in pregnant women is more difficult, the possible Negative influence to the fruit. Antibiotics used in the schemes should not have teratogenic, embryotoxic and fetotoxic effects.

1 Azithromycin 1.0 once;
2 Amoxicillin 500 mg 3 times a day - course 1 week.

Alternative drugs include:

1 Erythromycin 500 mg 4 r / c - course 1 week;
2 Erythromycin 250 mg 4 times a day - a course of 2 weeks.

Previously, josamycin was included in the standard treatment for chlamydia during pregnancy.

6. Correction of the immunological status

Treatment of chlamydia in full is impossible without a full correction of the immune disorders that have arisen. To do this, antibiotic therapy should be combined with the use of immunomodulatory drugs such as cycloferon, viferon or neovir.

Mandatory measures aimed at increasing the overall immunoreactive capabilities of the body. By using modern methods diagnostics (ultrastructural analysis), it was proved that the addition of antibiotic therapy with immunomodulators turns the incomplete process of phagocytosis, characteristic of chlamydia, into a completed one.

Some authors (Glazkova, Polkanov) prefer a stepwise scheme of chlamydia eradication. They recommend at the first stage to increase the general nonspecific immunity of the body with the help of immunomodulators, and then at the second (main) stage to carry out eradication therapy with antibiotics.

The final stage, in their opinion, is the stage of restoration of the body with the use of systemic adaptogens, courses of antioxidants.

A number of Russian researchers claim that the addition of interferons to the treatment regimen not only increases the success rate of therapy, but also significantly reduces its duration.

The highest treatment efficiency (up to 95%) was achieved with complex therapy of chlamydia with antibiotics, enzymes and interferon preparations (exogenous or synthesis inducers). The safest today are immunomodulators in dosage forms for topical use.

6.1. Immunomodulators: groups, effectiveness evaluation

All immunomodulators can be conditionally divided into two large groups:

1 Exogenous (introduced from outside) interferons;
2 Stimulators (inducers) of the synthesis of its own interferon.

In the complex treatment of chlamydia, preparations of artificial exogenous interferon are more often used, inducers of the synthesis of one's own interferons are only promising means.

Fusion inducers are a large, diverse family of natural and synthetic compounds. Unlike exogenous interferons, inductors do not have antigenic properties, and their synthesis is completely controlled by the human body.

The most studied drug of this group is cycloferon. It is a water-soluble synthetic analogue of a natural natural alkaloid. In lymphoid tissues, the drug stimulates the production of interferon.

The drug has a high biological activity and has no carcinogenic, mutagenic and embryotoxic effects.

It is excreted by the kidneys in a day unchanged, does not accumulate in the body and does not have a toxic effect on the liver (250 milligrams intramuscularly every other day for 20 days).

Enzyme therapy is also considered an adjuvant therapy. In the Russian Federation, the treatment of urogenital chlamydia is often supplemented with systemic enzyme preparations (wobenzym, phlogenzym). The combined use of enzymes and antibiotics increases the concentration of the latter in the inflammatory focus. The drugs do not have an evidence base, their use is not justified at the international level.

7. Criteria for cure

The main criteria for the success of therapy are eradication (elimination) of the pathogen and relief of symptoms of infection. Laboratory monitoring of the effectiveness of treatment should be carried out no earlier than 1 month after the completion of the course of antibacterial drugs (when using PCR).

The low effectiveness of treatment may be due to:

1 Reinfection, lack of treatment of the sexual partner.
2 Antibiotic resistance.
3 Long-term persistence of the pathogen.

If the first course is ineffective, you can continue treatment with antibiotics of another group.

The most common sexually transmitted disease is chlamydia. Treatment in women is complicated by the absence of severe symptoms in many cases. In the meantime, the disease progresses, complications develop. Statistics has data that over 140 million people are infected every year. What causes the disease, its symptoms, possible complications and what is the effective treatment of chlamydia in women - we will consider in this article.

What is chlamydia?

Chlamydia is a range of diseases caused by different types of the bacterium Chlamydia. These microorganisms cause skin diseases, pneumonia and other respiratory diseases. One of the types of chlamydia, namely Chlamydia trahomatis, contributes to the occurrence of urogenital chlamydia.

But usually at this stage, chlamydia is not treated in women, drugs are not taken, since often an infected person does not know about the disease due to the absence of symptoms. Meanwhile, the bacterium multiplies and new lesions appear. The incubation period of chlamydia is up to a month, depending on the person's immunity.

Ways of infection

Genital chlamydia is transmitted sexually. Oral contraceptives and coitus interruptus cannot protect against infection. Infection occurs in 70% of cases with unprotected intimate relationships with a partner - a carrier of the bacterium.

Chlamydia is transmitted from an infected mother to a newborn child both in utero and during labor. In medical science, there is controversy over the possibility of transmission of bacteria in the household through general funds personal hygiene and linen. It is known that chlamydia can exist in the external environment for up to 2 days. They only die when processed. high temperature. But what is the probability of human infection in this case - there is no consensus.

Forms of the disease

In medicine, there are two forms of chlamydia, depending on the degree of damage and the duration of the disease. Each of them has its own symptoms and individual treatment regimen. The classification is as follows:

The fresh form affects the lower part of the genitourinary system. The duration of the disease is up to 2 months.
When bacteria spread to the lower urinary tract and how long life cycles more than 2 months, then doctors diagnose "chronic chlamydia". Treatment in women in this case involves additional, often combined antibacterial drugs.

Medical statistics states that in 67% of chlamydia infections, the disease is completely asymptomatic. In this case, the disease manifests itself only in the stage of chronic course and the development of complications with the corresponding symptoms. Most often, severe symptoms appear only when the chronic stage of chlamydia development is advanced and are manifested as follows:

burning in the urethra and vagina;
itching of the genitals;
cloudy discharge with an unpleasant odor;
pain during urination;
pulling pain in the lower abdomen;
discomfort during intercourse;
spotting in the middle of the menstrual cycle;
increased body temperature;
violation of the menstrual cycle.

Causes of chlamydia

The reasons for the large-scale spread of chlamydia is the lack of public awareness about the problem, especially among adolescents. Few people know how chlamydia is treated in women. The drugs needed to fight the disease, meanwhile, cause additional harm to the health of the young body, acting quite aggressively on it and having a number of side effects.

Contribute to bacterial infection: early onset of sexual activity, random change of partners, sexual intercourse unprotected by a condom.

What is dangerous for a woman

This begs the question of what is so terrible about chlamydia, if in most cases the disease does not manifest itself with any pain symptoms? The answer is unequivocal - the disease is dangerous by the development of serious complications. In the absence of the necessary treatment, chlamydia can affect the reproductive organs and contribute to the occurrence of such pathological processes:

cervicitis or inflammation of the cervix;
pathological processes in the uterus, ovaries, fallopian tubes;
adhesive processes in the pelvic organs;
endometritis - the endometrium of the uterus;
cystitis and urethritis;
as a result of complications - infertility.

The risk of chlamydia during pregnancy

Chlamydia is extremely dangerous in pregnant women. Treatment is complicated by the inability of the patient to take a number of necessary medications, since most of them can have an extremely negative effect on the development of the fetus. The asymptomatic course of the disease, and, accordingly, its late detection and untimely treatment can lead to complications or termination of pregnancy: fever, polyhydramnios, non-developing pregnancy, rupture of the membranes, miscarriage or premature birth. Increasing chance of developing ectopic pregnancy if conception occurred in the presence of an infection in the body of a woman. In 30% of cases, the fetus is infected in utero, and in 40% the child is infected during passage through the birth canal.

What is dangerous for the child

Diagnosis of chlamydia

A gynecologist can suspect the presence of an infection during a general examination with the help of mirrors. He will be able to detect symptoms characteristic of most diseases of the reproductive system: inflammatory processes, areas of erosion, a large amount of secretions, their corresponding consistency, color and smell.

To confirm the diagnosis and identify the causes of pathological processes, the specialist will take a swab from the vagina for bacteriological analysis. A general smear cannot detect the presence of chlamydia, but it will detect other sexually transmitted infections that often develop in parallel with chlamydia.

A blood test to determine antibodies to chlamydia also cannot confirm the diagnosis with certainty. Since the presence or absence of antibodies cannot reliably indicate the presence of a living bacterium in the body.

PCR - diagnostics is carried out to determine the DNA of chlamydia. The material for analysis is vaginal discharge. Positive result analysis will reliably confirm the presence of infection. But if negative, more research is needed.

Bacterial culture is the most reliable way to detect chlamydia. Material for analysis (discharge from the vagina) is placed in a favorable environment for chlamydia. Then, after the time necessary for the growth and reproduction of bacteria, the presence or absence of such is determined under a microscope.

Treatment methods for chlamydia

The disease is treated with general and local methods. The main treatment for chlamydia in women is antibiotics. The treatment regimen is developed by the doctor in individually. When choosing an antibacterial agent, the following factors should be considered:

In addition to antibacterial agents, immunomodulatory drugs, probiotics, and enzymes are prescribed.

Chlamydia treatment regimen

Upon confirmation of the diagnosis, it is necessary to prescribe proper treatment chlamydia in women. The scheme is as follows:

1. Macrolides for the treatment of chlamydia have the highest efficiency:

drug "Erythromycin": 0.5 g 4 times a day for 2 weeks;
means "Josamycin": 1 g one-time, then 0.5 g twice a day for 10 days;
medicine "Spiramycin": three times a day, 3 million IU for 10 days;
drug "Klacid": twice a day, 250 mg for 14 days.

2. Fluoroquinolones are used less frequently, since many types of bacteria are resistant to this type of antibiotics:

means "Ofloksatsin": one tablet twice a day for 10 days. If ineffective, the doctor may increase the dosage;
medicine "Lomefloxacin": 1 tablet once a day, 10 days is used for uncomplicated forms of chlamydia;
the drug "Pefloxacin": 600 mg once for 7 days.

3. Broad-spectrum antibiotic "Clindamycin" is taken 2 tablets 4 times a day for a course of 7 days. By using this drug there is an effective treatment of chlamydia in women. Reviews indicate the majority of cases of complete cure and the minimum number of adverse reactions to the drug.

Immunomodulatory therapy helps the body build up the strength to fight infection when chlamydia is being treated in women. The drugs are prescribed as follows: the remedy "Cycloferon" in a course of 5 injections according to the prescribed scheme in parallel with taking antibiotics. And the drug "Neovir" of 7 injections of 250 ml every 48 hours after a course of antibiotics.

Antibiotics have an extremely negative effect on the microflora of the gastrointestinal tract. To prevent the development of stomach diseases, enzyme preparations and probiotics are prescribed: Bifidumbacterin, Lactobacterin, Chlorella, Hilak-forte and others.

Local treatment of chlamydia

In addition to general therapy, the gynecologist also prescribes local treatment for chlamydia in women. Candles have anti-inflammatory and antibacterial properties. Dimexide solution is also used in the form of tampons, antibacterial gels and creams, douching. To restore the body's strength, the doctor will prescribe a complex of multivitamins, for example, Supradin. During the treatment of the infection, you must refrain from sexual intercourse or use a condom.

Physiotherapy procedures

In the treatment of chlamydia, especially in the chronic form, effective additional methods of treatment are physiotherapy methods:

low frequency ultrasound;
local laser phoresis;
electrophoresis;
UFOK.

Treatment of chronic chlamydia

If a doctor has diagnosed "chronic chlamydia", in women the treatment involves the following scheme:

Injections of drugs "Neovir" or "Cycloferon" every other day 7 times.
Means "Rovamycin" begin to take 3 million IU three times a day after the third injection of cycloferon. The course of treatment is 14 days.
The drug "Diflucan" 1 capsule on the 7th and 14th day of treatment with the main antibiotic.
Vitamin complexes.
Physiotherapy procedures according to indications.

Treatment during pregnancy

Antibiotic therapy as prescribed by a doctor: preparations "Erythromycin", "Rovamycin", "Sumamed".
Immunomodulating therapy with the help of such drugs, suppositories, which include substances such as myelopid, econazole nitrate or interferon.
Probiotic preparations in the form of topical suppositories and oral agents.

Confirmation of cure

Since chlamydia is rarely manifested by severe symptoms, and their absence cannot be judged in any way. effective treatment diseases, after passing the drug course of fighting the infection, it is imperative to conduct control tests in several stages and by different methods:

Prevention of chlamydia

Chlamydia is a serious complication. Treatment in women is carried out with antibacterial drugs that have an adverse effect on various internal organs. Preventive methods will help to avoid many health problems, namely: a responsible attitude to own health, which manifests itself in the exclusion of promiscuity and the passage, the use of barrier methods of contraception and regular medical examinations. To prevent complications during pregnancy and during its planning, it is necessary to be tested for chlamydia and other sexually transmitted infections.

Chlamydia is insidious asymptomatic and rapid spread. Therefore, the lack of treatment or independent attempts to fight the infection can lead to unforeseen consequences and serious damage to the health of the infected person and his partner. Seeing a doctor will help prevent the development of complications and overcome the disease.

For Russia, as for most European countries, a serious problem is the depopulation of the population. After the dramatic demographic situation in the post-Soviet period, the birth rate in the Russian Federation is currently still unstable.

It should be noted that throughout the world, low rates of natural population growth are observed even in the most favorable countries in terms of quality of life.

In addition, changes regarding the age pyramid do not inspire optimism: the world's population is steadily aging, not only in Europe, but also in Africa. In this regard, the strategic challenge facing Russian Federation, — stabilization of the country's population.

In addition to purely socio-economic reasons, the leading place in the demographic crisis, of course, is occupied by the problem of male and female reproductive health.

It is known that about 40% of the causes of infertility in a couple are associated with the male factor, while 70% of men have oligoasthenoteratozoospermia, and 13% have azoospermia.

According to current ideas, the basis of the violation of the mechanism of male fertility is hormonal imbalance, testicular pathology, genetic disorders, hereditary factors, autoimmune aggression.

Recently, there has been increased interest in the study of excessive production of reactive oxygen radicals (ROS) by sperm polymorphonuclear leukocytes, which are the cause of oxidative stress, leading to damage to the spermatozoa membrane, a decrease in spermatozoa motility and a violation of their fertilizing ability.

It has been established that damage to nuclear DNA, which causes dysfunction of spermatozoa, is the main cause of non-developing pregnancy, affects the development of the embryo and implantation, and increases the risk of spontaneous abortion several times.

A significant place in the development of the pathology of the reproductive organs is occupied by a wide range of uropathogenic and opportunistic microorganisms, including the colonization of the genitourinary system with sexually transmitted infections (STIs), which entail pathological changes in the ejaculate.

Violation of male fertility as a result of the infectious and inflammatory process of the urogenital tract is directly related to the hyperproduction of ROS, impaired function or patency of the epididymis, and pathological stimulation of the production of antisperm antibodies.

Another significant factor leading to a decrease in male fertility is prostatitis.

It is known that a change in the secretory function of the gland leads to a violation of the quantitative and qualitative composition of the seminal fluid, and the toxic effect of microorganisms and their metabolic products has a detrimental effect on spermatogenesis in general. There is evidence that chronic prostatitis leads to an increase in the production of ROS in semen by an average of 8 times.

Urogenital chlamydia

In all countries of the world, the problem of the incidence of chlamydial infection, which dominates in the frequency of detection among all STIs, does not lose its relevance.

Urogenital chlamydia caused by C. trachomatis (serovars D to K) occupies one of the leading places among STIs in terms of damaging effects on the human reproductive system.

According to the frequency of occurrence of the most common pathogens of non-gonococcal urethritis C. trachomatis takes from 11% to 43%, while M. genitalium– from 9% to 25%, Tr. vaginalis— from 1% to 20%. At the same time, 65% of all observations fall on the share of men.

Along with T. pallidum, N. gonorrhoeae, Tr. vaginalis and M. genitalium, C. trachomatis is an absolute pathogen and is subject to mandatory sanitation due to high risk development of severe complications.

Despite the programs adopted in many countries of the world to combat STIs, there is no decrease in the incidence of urogenital chlamydial infection. For example, in Europe, 600 thousand new cases of chlamydia are registered annually.

Meanwhile, the incidence rate does not reflect real statistical indicators, since it is believed that 40-50% of men with chlamydia are asymptomatic, which in turn increases the risk of developing serious complications and further spread of the infection.

In our country, the problem of chlamydia, as well as the problem of STIs in general, seems to be even more significant due to the change in last years a model of the sexual behavior of the population, a decreased age of sexual debut, an increase in the level of general promiscuity and an influx of labor migrants from neighboring countries.

It is important to note that chlamydia often occurs in asymptomatic and subclinical forms, which is extremely important from an epidemiological point of view; it can be diagnosed not only as a monoinfection, but is also detected along with other bacteria and viruses and their combinations, aggravating the course of the pathological process.

Besides, C. trachomatis It is also a factor in ROS hyperproduction, leading to oxidative stress with subsequent disruption of adequate chromatin packaging, causing DNA fragmentation, and initiating mediated apoptosis of spermatozoa.

Clinical manifestations of chlamydial infection

In men, the main manifestation of chlamydia is urethritis, which manifests itself in the form of scanty mucous or mild mucopurulent discharge, which is often accompanied by burning, itching, and sometimes dysuria that occurs several days or weeks after unprotected sexual contact. In addition to torpid urethritis, colonization of the genitourinary system with chlamydial infection can lead to the development of complications such as epididymitis, funiculitis, and prostatitis associated with urethritis, which inevitably increases the likelihood of subsequent pathospermia.

In addition, at various options sexual activity may occur chlamydial pharyngitis, chlamydia of the anorectal region, chlamydial conjunctivitis. In some cases, urethrooculosynovial syndrome (urethritis, conjunctivitis, reactive arthritis) is diagnosed.

Chronic prostatitis associated with chlamydial infection

In recent years there has been renewed interest in chlamydial infection as a factor in the initiation of chronic prostatitis. Formally C. trachomatis is an unproven, but quite likely cause in the development of prostatitis. Practical observations indicate that it is chlamydia that is often the leading infectious agent in the etiology of chronic prostatitis.

The basis for this assertion is the identification C. trachomatis in the secret of the prostate in the absence of other urinary tract infections against the background of the characteristic symptoms of chronic prostatitis and leukocytosis in the secret of the prostate gland.

Diagnosis of chlamydia

Verification of the diagnosis of chlamydial infection is based on the results of laboratory research methods using highly sensitive and specific methods of nucleic acid amplification (NAAT) or isolation C. trachomatis in McCoy cell culture ("gold standard").

It should be emphasized that screening methods such as direct immunofluorescence (DIF) and serological studies (ELISA) are not currently used due to their insufficient sensitivity and low information content.

Treatment

The main goal of the treatment of chlamydial infection is eradication. C. trachomatis and resolution of clinical manifestations of infection.

It is important to note that the detection of chlamydia in a patient requires preventive treatment of the sexual partner.

In the European Association of Urology (EAU) recommendations for the treatment of STIs and the recommendations of the International Union against Sexually Transmitted Infections (IUSTI) (2011), as well as in the Russian national guidelines for antimicrobial therapy and prevention infections of the kidneys, urinary tract and male genital organs, fluoroquinolones (levofloxacin) are indicated among alternative drugs in the treatment regimens for chlamydia.

In addition, levofloxacin is known to be the only FDA approved fluoroquinolone in the US. food products and drugs (Food and Drugs Administration of the United States, FDA) as the drug of choice in the treatment of urinary tract infections (non-gonococcal urethritis, urogenital chlamydia, gonococcal infection and chronic bacterial prostatitis).

The general principles of therapy for uncomplicated and complicated forms of chlamydial infection are presented in Table. 1 and 2.

It should be emphasized that complicated forms of chlamydia (epididymitis, orchitis, prostatitis) require an increase in the duration of antibacterial treatment for a period of 14 to 28 days.

In addition, it is known that in the treatment of patients with chronic prostatitis, only alpha-1-blockers, non-steroidal anti-inflammatory drugs and fluoroquinolones (levofloxacin) meet the requirements of evidence-based medicine.

On the pharmacological market of Russia, levofloxacin is represented by several drugs, one of which is Remedia (active substance levofloxacin hemihydrate 256 mg/512 mg/768 mg, equivalent to levofloxacin 250 mg/500 mg/750 mg).

Remedia is a broad-spectrum antimicrobial bactericidal agent from the group of fluoroquinolones. The active substance contains levofloxacin, a levorotatory isomer of ofloxacin.

The aim of this study was to investigate the efficacy and safety of the 3rd generation fluoroquinolone levofloxacin, trade name Remedia, in the treatment of chronic bacterial prostatitis (CKD) and chronic prostatitis (CP) associated with urogenital chlamydia.

Materials and methods of research

Under observation were 48 men aged 32 to 52 years. Patients were divided into 2 groups: group 1 (14 people) - patients with exacerbation of chronic pancreatitis who applied with characteristic clinical manifestations of prostatitis; Group 2 (34 people) - men who applied for examination before planning a pregnancy in the family. After a standard andrological clinical and laboratory examination and on the basis of microscopic and bacterioscopic examination of discharge from the urethra and secretion of the prostate (PJ) / semen, the diagnosis of CKD was established in 14 patients of the 1st group. In 28 men of the 2nd group, CP was diagnosed (category IV) and in another 6 patients, CP was associated with chlamydial infection ( C. trachomatis detected in McCoy cell culture). At the same time, in patients of the 2nd group, against the background of CP and bacteriospermia, violations of normal sperm parameters (asthenozoospermia, asthenoteratozoospermia, spermagglutination, leukospermia) were noted.

In all patients, the pathogens identified during bacterioscopic examination were sensitive to Remedia. The drug is presented in three dosages of 250, 500 and 750 mg. Patients with CKD were treated with Remedia at a single daily dose of 500 mg daily for 20 days; in men in whose families pregnancy was planned, who had impaired fertility and CP (category IV) and CP associated with chlamydia, the duration of treatment was 10 days, the drug was administered at a dose of 500 mg 1 time per day.

In addition to the basic Remedia therapy, all men simultaneously received a course of physiotherapy with a traveling magnetic field (Intramag device), and to achieve better elimination of the pathogen from the body, they used immunomodulating rectal suppositories Polyoxidonium or Longidase.

The effectiveness of Remedia was evaluated after 10-14 days in patients with CKD and after 21-30 days in patients with CP and chlamydia. The assessment was based on the data of microscopic and bacterioscopic examination of the pancreas/sperm; in men of the 2nd group, the spermogram and control were also examined. C. trachomatis.

Microbiological cure was noted in all cases, the number of leukocytes in the secretion of the pancreas/ejaculate reached normal values. At the same time, in 14 patients with CKD, the symptoms of prostatitis completely resolved, and in men with an asymptomatic form of CP and concomitant pathospermia, the ejaculate parameters approached normal values "in the control - C. trachomatis not identified.

conclusions

Our studies confirm the results of previous clinical studies of levofloxacin, indicating its high therapeutic efficacy in the treatment of almost all forms of urogenital infection.

The pharmacokinetic profile, the excellent ability of the active substance to penetrate into the pancreatic tissue, the ease of use of Remedia (1 time per day) allow us to recommend it as one of the highly effective antibacterial agents in the treatment of patients with CKD and CP associated with chlamydial infection. unwanted side effects none of them were noted.

Urogenital chlamydia is one of the factors that cause violations of the fertilizing ability of spermatozoa.

Literature

Bozhedomov V. A., Gromenko D. S., Ushakova I. Ya. Causes of oxidative stress // Problems of reproduction. 2008, vol. 14, no. 3, p. 63-67.
Toroptseva M.V. The role of oxidative stress in the pathogenesis of various forms male infertility. Abstract dis. for the competition uch. step. PhD M., 2009.
V. A. Bozhedomov Chronic prostatitis: clinical and immunological aspects // Effective pharmacotherapy. 2013, no. 16, p. 8-10.
Perepanova T. S. Urethritis and urethral syndrome // Effective pharmacotherapy. 2013, no. 16, p. 6-10.
Karen L. Hart G. Knowledge of C. trachomatis among men and women approached to participate in common-based screening Scotland // UK BMC Public Health. 2010, 10, 794.
Workowski K., Berman S. Centers for Disease Control and Prevention (CDC). Sexually Transmitted Diseases Treatment Guidelines, 2010 MMWR Recomm. Rep., 2010, 59 (RR-12): 1-10.
Lushnikova E., Nepomnyashchikh, Abdullaev N. Role of sexually transmitted infections in the structural and functional reorganization of prostate Bull // Exp. Biol. Med., 2012, v. 153, No. 2, p. 283-288.
Sadrpour P.,., Bahador A.., Asgari C. Detection of C. trachomatis and Mycoplasma Genitalium in semen samples of infection view using PCR // Teheran University Medical Journal. 2013. V. 70, No. 10.
Kondratieva Yu. S., Neimark A. I., Erkovich A. A. Clinical and morphological features of chronic urethroprostatitis associated with chlamydial and mycoplasmal infection // Bulletin of Siberian Medicine. 2012, No. 2, 24-30.
Grabe M., Bishop M., Bjerklund-Johanson T. et al. Guidelines on urological infections // European Association of Urology. 2009. p. 78.
Lanjouw E., Osserwaard J. et al. European Guideline for the management of Chlamydia trachomatis infections // Int. J. STD AIDS. 2010,v. 21, No. 11, p. 729-737.
Russian National Guidelines for Antimicrobial Therapy and Prevention of Infections of the Kidneys, Urinary Tracts and Male Genital Organs. M., 2012. S. 38-40.
Pushkar D. Yu., Zaitsev A. V. Modern treatment of urinary tract infections // Bulletin of a practical doctor. 2012, no. 1, p. 3-7.
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V. B. Stoyanov 1 Candidate of Medical Sciences
S. Yu. Fominykh
T. B. Semyonova, doctor of medical sciences, professor

Herpetic Center LLC, Moscow

Among the most common sexually transmitted diseases, trichomoniasis and chlamydia occupy a leading position. The clinical manifestations of these pathologies are largely similar, and the methods of diagnosis and treatment are not very different.

The main danger of chlamydia and trichomoniasis is that they negatively affect the human reproductive system, so you should know the methods of prevention to avoid infection.

Symptoms of both pathologies are more pronounced in women, in men they often occur in a latent form, without any special signs, which makes timely treatment difficult.

Are trichomoniasis and chlamydia the same thing? Both infections can develop at the same time, since chlamydia and Trichomonas often live simultaneously in the human body.

Symptoms of trichomoniasis

Manifestations of pathology

Signs of trichomoniasis in women

Signs of trichomoniasis in men

Pulling pain in the lower abdomen, sometimes in the anal region, pain during urination, swelling of the external genitalia.

Fever, profuse discharge with impurities of pus, blood with a pungent odor.

Disruptions in the menstrual cycle.

In advanced forms of the disease, cystitis and pyelonephritis develop.

On examination, the doctor can see many small hemorrhages on the cervix.

Itching, discomfort in the genital area, groin, pain can radiate to the back, leg, discomfort during intercourse, urination.

Inflammation of the foreskin

copious discharge from the urethra, most often in the morning.

With a weakened immune system, the temperature rises, with prolonged infection, discharge from the urethra appears, the quality of sperm deteriorates, and there are problems with potency.

Signs of chlamydia

Symptoms of chlamydia

Combined infection treatment

If unpleasant symptoms appear, it is necessary to visit a gynecologist, urologist or venereologist. Diagnosis of diseases that are sexually transmitted includes taking a smear from the vagina, urethra, cervical, urethra, PCR, clinical blood and urine tests.

Based on the results obtained, the doctor selects drugs that can destroy all types of pathogenic microorganisms.

If treatment is not started in a timely manner, then in men, against the background of sexual infections, urethritis, prostatitis develop, sexual desire decreases, and infertility is possible.

The inflammatory process covers the testicles, seminal vesicles. In women, trichomoniasis and chlamydia can cause adhesions, inability to conceive. Pathogenic microorganisms can cause miscarriage or premature birth during pregnancy.

How to expel chlamydia?

For the treatment of chlamydia, antibacterial drugs are used, in order for the therapy to be effective, it is necessary to first do tests for the sensitivity of microorganisms to the active substance of the drug.

The drug of choice in the treatment of chlamydia is often Doxycycline from the tetracycline group. Despite the long-term use of this medicine, pathogenic microorganisms have not developed immunity to it. Reception schedule - on the first day, 200 mg in the morning and evening, then 100 mg twice a day.

Well helps to cope with chlamydia Azithromycin (Sumamed) - on the first day you need to take 500 mg of medication in the morning and evening, then 500 mg once a day every other day for a week.

How to treat chlamydia:

macrolides - Clarithromycin, Fromilid, 500 mg twice a day for 7 days;
rifamycins - Rifampicin;
fluoroquinols - Ciprofloxacin, Tsiprobay, Ofloxacin;
antimycotic drugs - Flucostat, 50 mg once a day for a week;
suppositories - Hexicon, Vagilak, administered anally or vaginally;
means for restoring microflora - Linex, Hilak-forte;
local preparations - Erythromycin, Tetracycline ointment.

The average duration of therapy for chlamydia is 1-2 weeks. Additionally, immunomodulators, vitamin complexes are prescribed.

In the treatment of chlamydia in pregnant women, Erythromycin is used - 500 mg every 6 hours for a week, or 250 mg four times a day for 2 weeks. The same drug is also used to treat children - the dosage is 50 mg / kg. Reception should be continued for 10-14 days.

At chronic chlamydia before starting antibiotic therapy, a course of injections of Polyoxidonium is preliminarily administered or Interferon is prescribed to strengthen the patient's immunity.

Reliable ways to get rid of Trichomonas

The main drug for the treatment of trichomoniasis is Metronidazole and its derivatives. The drug is available in the form of tablets and vaginal suppositories, which allows you to effectively treat the infection in women and men. The duration of treatment is 7-14 days.

Tinidazole, Ornidazole, Macmirror, antibiotics from the tetracycline group are used as additional drugs.

Is it possible to treat venereal diseases with folk remedies?

Alternative medicine methods will not help get rid of chlamydia and Trichomonas, but they can enhance the therapeutic effect of drugs, speed up the healing process.

One of the effective methods of combating genital infections is douching with garlic tincture. It should be poured with 500 ml of alcohol 50 minced garlic, sent to a dark place for 14 days, shaken daily.

Strain the resulting tincture, dilute with water in a ratio of 1:10 before the procedure. For one session, 300 ml of solution will be required.

Juice therapy also helps a lot - add 60 ml of beetroot and cranberry juice to 120 ml of blackcurrant juice. Drink a drink in the morning and evening after meals for a month. This method of treatment helps to strengthen the immune system, is effective in chronic infections.

Prevention of STDs

To avoid infection with sexually transmitted diseases, you must be careful about choosing a sexual partner, use barrier contraceptives, do not use other people's underwear, washcloths, towels.

The story of a qualified specialist about the treatment of combined STIs:

Strict observance of the rules of personal hygiene is the main rule for preventing various sexual infections.

Prevention of sexually transmitted diseases consists in regular visits to the doctor, partners should pass all the necessary tests at the stage of pregnancy planning in order to avoid miscarriage, premature birth, infection of the fetus.

Trichomoniasis and chlamydia are dangerous sexually transmitted diseases that adversely affect the functioning of the genitourinary and reproductive system Is it possible to cure diseases permanently?

Alternative opinion. Visiting Dr. Komarovsky, obstetrician-gynecologist Sergei Baksheev talks about commercial diagnoses in gynecology, among which he names chlamydia:

With timely diagnosis and proper therapy, it is possible to get rid of pathologies without consequences and complications in 2 weeks. If you start the infectious process, then it will turn into a chronic form, it will take a long and not always successful treatment.

Antibiotics for ureaplasma: determination of sensitivity and review of the best

The doctor also determines the individual sensitivity of microorganisms in order to determine which drugs to treat.

An untreated disease often causes premature birth in pregnant women, inflammation of the uterus and appendages, urolithiasis, pyelonephritis, cystitis and other serious diseases. The treatment takes into account the age of the patient, the presence of concomitant infections, the severity of the disease.

For the treatment of ureaplasma, an increased concentration of the drug is necessary, in connection with this, therapy is long and usually takes at least ten days.

The form of release of antibiotics is represented by the following types:

Antibiotics are available in tablet form and as solutions for injection. For patients with ureaplasmosis, the doctor prescribes taking pills in conjunction with vitamin and immune-supporting drugs.
The dosage of all drugs may be different, depending on which drugs are taken. The well-known drug Clarithromycin is available only in the form of tablets with a dosage of 250 and 500 mg. One pack of medicine contains ten tablets coated with a special coating for easy swallowing. for sale this remedy in packages or plastic containers.
The treatment regimen and dosage of the solution for injection is determined solely by the attending physician after passing all the tests. This medicine is available in special vials and may have a different dosage.

The price of drugs varies, depending on the form of release, name and manufacturer.

Treatment with antibiotics against ureaplasma during pregnancy

As you know, during pregnancy, it is necessary to protect yourself as much as possible from taking medications, since any remedy can adversely affect the condition of the mother and the unborn child. This is especially true for antibiotics taken for early stage fetal development.

When are antibiotics contraindicated?

The use of antibiotics for the treatment of ureaplasmosis is contraindicated in the presence of an allergic reaction to the active substance of the drug. In this regard, when choosing a medicine, it is necessary to pay attention to which components are included in its composition.

Thus, taking antibiotics against ureaplasma can only be justified with a competent approach to treatment. Medicines should be selected exclusively by the attending physician, self-medication is excluded.

With an overdose of antibiotics, the patient may experience the following types of complications:

An allergic reaction, the most dangerous of which may be anaphylactic shock;
Defeat gastrointestinal tract, liver, kidneys;
Penetration of the active substance through the placenta, which leads to the occurrence of congenital pathologies in the fetus.

Complications usually develop when the rules for taking the drug Ofloxacin (Levofloxacin), Macropen, Erythromycin and other drugs are not followed.

At the first symptoms of an overdose, you should immediately seek medical help.

Treatment with antibiotics against ureaplasmosis

Treatment for ureaplasma is carried out by taking the following groups of drugs:

tetracycline;
lincosamide;
macrolide;
aminoglycoside;
fluoroquinolone.

Of the antibiotics included in the tetracycline group, the drug Doxycycline is considered the most effective for ureaplasma. Compared to traditional tetracycline, this drug is considered safer.

The active substance doxycycline monohydrate, which is part of many similar drugs, has a less detrimental effect on the intestinal microflora.

Meanwhile, such antibiotics are teratogenic, so they are contraindicated for pregnant women and children under 8 years of age.

The drugs Ofloxacin (Levofloxacin), Ciprofloxacin, belonging to the group of fluoroquinolones, are distinguished by high bactericidal activity and effective medicinal property. This group of antibiotics is not recommended for pregnant women.

Lincosamides are antibiotics of natural origin. Among which is the drug Lincomycin. Its synthetic analogue is the drug Clindamycin.

Treatment of ureaplasmosis is usually carried out with a single antibiotic. However, there are cases when therapy does not bring the desired result and the inflammatory process does not stop. Then the doctor can prescribe the intake of two antibiotics, the scheme and duration of treatment are discussed in advance.

Modern medicine has developed a table that lists the sensitivity and resistance of ureaplasma to certain types of drugs. According to the data, ureaplasma is most sensitive to the drug Macropen, Duxicycline, Ofloxacin (Levofloxacin), Clindamycin, Gentamicin.

The drug Erythromycin, Pefloxacin and Tetracycline have a sensitivity of less than 50 percent. Most low level resistance in the drug Macropen and Duxicycline. The most unstable antibiotics are Erythromycin, Pefloxacin and Tetracycline.

Thus, given sensitivity and resistance, the most effective against ureaplasmosis are medicines Macropen and Duxicycline. Meanwhile, the antibiotic drug Erythromycin is approved for pregnant women, which is a significant plus.

The drug Ofloxacin (Levofloxacin) has a very positive reviews doctors and patients. It has the ability to be instantly absorbed, so that it acts on the body quickly and effectively.

This is a rare type of tablet that has almost complete bioavailability.

When choosing a dosage, it is important to consider that Ofloxacin (Levofloxacin) tablets should not be divided or crushed. The drug is taken twice a day, 400 mg for seven to ten days.

A similar drug is Ciprofloxacin, which also belongs to fluoroquinolones.

How to treat chlamydia - an effective treatment regimen

Symptoms of chlamydia
Ways of infection with chlamydia
Diagnostics

macrolides
Tetracyclines
Fluoroquinolones
Cephalosporins
Immunostimulants

Consequences of chlamydia