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1346 women with the symptoms of chronic recurrent urogenital infection were examined. The diagnosis of genital candidiasis was confirmed by the clinical manifestations (not less than its 4 episodes a year) and laboratory tests: budding fungal cells, mycelium and/or pseudomyselium in the vaginal smears detected microscopically, growth of Candida spp. on the Sabouraud's medium. The species of the isolates were determined by the standard morphological and biochemical tests. The in vitro susceptibility to fluconazole and voriconazole was evaluated by the disk diffusion method (Protocol CLSI M44-A). The frequency of chronic recurrent genital candidiasis in women with chronic urogenital infection amounted to 19%. The pathogens of the disease belonged to 12 species of Candida. The main pathogen was Candida albicans (83%). Most of the isolates (88%) were susceptible to fluconazole. 99.5% of the isolates was susceptible to voriconazole. The isolates resistant to fluconazole mainly belonged to non-albicans (41% vs. 1% of Candida albicans) and were obviously more frequent under the following conditions: the age of the females above 36 years (including the periods of peri- and postmenopause), frequent relapses (at least 7 a years), atypical clinical and laboratory signs.

The results of complex treatment of 235 patients with persisting urogenital chlamidial infection are presented. The treatment regime included immunotropic agent interferone alfa-alpha 2b and antibiotic azithromycin (Sumamed, "Pliva", Croatia) 1 g per day 3 times every 7 days. Chlamidial persistence diagnosis was performed by culture method (determination of small cytoplasmic inclusions), by the method of immune fluorescence and PCR. The treatment provided positive influence on immune status (amount of CD4+; HLA-DR+ cell and IgA level normalized after the treatment). In 3 months after the treatment only 2 cases of Chlamydia trachomatis infection recurrence were registered. Treatment efficacy achieves 94.8 per cent.

Complex examination of 40 female in- and outpatients at the age 20 to 42 years with inflammatory urogenital diseases was performed. To verify the diagnosis, current clinical, microbiological, endoscopic and ultrasonic procedure were used. It was shown that the inflammatory processes in the urogenital tracts were mainly due to association of opportunistic and/or pathogenic organisms. Optimization of antibacterial therapy of urogenital infections was found possible with using homeopathic agents in the complex therapy. The significance of cooperation of the allied specialists in the choice of the examination and therapy policy for female patients with inflammatory urogenital diseases is indicated.

In vivo effect of metronidazole on the active oxygen production by neutrophils in the peripheral blood of patients with urogenital chlamydial infection (9 females and 7 males) was studied with the use of luminol dependent chemiluminescence. Metronidazole was administered orally in a dose of 250 mg twice a day for 10 days. Blood for the specimens was collected prior to the treatment and on the next day of the treatment course completion. No effect on the spontaneous and zymozan or phorbol-12-myristate-13-acetate stimulated chemiluminescence was observed, although a significant increase in the chemiluminescence indices was stated in 3 females and 1 male. It was suggested that the changes in the individual values of the neutrophil chemiluminescence after the treatment were associated with the influence of metronidazole and/or its metabolites on the blood cells and with different activity of the host enzymes participating in the drug biotransformation.

The examination included 51 women. In 25.5 and 33.3 per cent of them gonorrhea and association of gonorrhea with trichomoniasis, chlamydiosis or ureaplasmosis and in 35.3 and 5.9 per cent chlamydiosis and association of chlamydiosis with trichomoniasis were stated respectively. 56.9 and 17.6 per cent of the women had the mixed infection in the urogenital tract and in extragenital foci respectively. The regimen of the chronic gonorrhea therapy included the use of ciprofloxacin in the initial dose of 500 mg and the subsequent doses of 250 mg every 12 hours, the course dose being 1.25 g. The efficacy of the treatment amounted to 100 per cent. The treatment of the patients with gonorrhea association with ureaplasmosis in a dose of 500 mg administered every 12 hours (the course dose of 5 g) resulted in eradication of ureaplasma in 71.4 per cent of the patients. The efficacy of the chlamydiosis treatment in the course dose of 10 g (500 mg every 12 hours) amounted to 88 per cent.

Pefloxacin mesylate is a broad spectrum fluoroquinolone active against pathogens with multiple resistance. Due to its high therapeutic efficacy (at last 90 per cent) and good tolerance pefloxacin mesylate is considered as the most promising drug in the therapy of severe infections and infections difficult for the treatment such as wound infection, meningitis and particularly perilous infections. Prolonged pharmacokinetics and high bioavailability of the drug provided its administration in the treatment of in- and outpatients with severe infection twice a day in a daily dose of 0.8 to 1.2 g. Pefloxacin proved to be a drug of choice in the treatment of infection due to intracellular pathogens.

The efficacy of cidipol used locally in the treatment of infectious inflammatory diseases of the urogenital tracts and in the prophylaxis of urinary tract infection (UTI) in transurethral instrumental interventions (TII) was studied microbiologically and clinically in 42 females at the age of 18 to 51 years. In the treatment of 23 female patients the drug showed good clinical effects. The eradication of the primary pathogen was stated in 16 patients. When used prophylactically before TII in 19 patients no infectious inflammatory complications were observed in any of the females. The data are evident of the possible use of cidipol in the treatment (local application) of infectious inflammatory diseases of the urogenital tracts in females and in the prophylaxis of UTI in TII.

The problems associated with the distribution, diagnosis, classification and treatment of urogenital tract chlamydiosis in Russia are discussed. Some arrangements for the improvement of the activities of the laboratory diagnostic services, the use of the International Classification of urogenital tract chlamydioses and the treatment optimization are offered. The drug of choice in the treatment of urogenital tract chlamydiosis is azithromycin (Sumamed, Pliva). Doxycycline, erythromycin and ofloxacin are recommended as the reserve drugs.

One hundred and fifteen females with nonsevere inflammatory diseases of the urogenital tracts were examined. Mixed chlamydial and gonorrheal infection was stated in 35 patients. In 38 patients chlamydial infection was diagnosed. To develop an optimal procedure for the treatment, the pharmacokinetics of azithromycin was studied. The results showed that the optimal primary dose of the drug was 1000 mg. Two regimens were recommended for the treatment of the patients. According to the first regimen azithromycin was administered in a single dose of 1000 mg. The efficacy amounted to 82.4 per cent in the cases with the mixed infection and to 89.9 per cent in the cases with chlamydiosis. According to the second regimen azithromycin was administered in a course dose of 3000 mg, the duration of the course being 9 days. The efficacy of the therapy amounted to 89.9 and 95 per cent respectively.

The actuality of the problem is conditioned by the persistence of residual inflammations in a significant number of the patients with urogenital infections after the completion of the etiotropic therapy. The main goal of the study was to develop a method for the treatment of post-gonorrheal and post-chlamydial colpitis, colpomycosis, endocervicitis and urethritis by local application of Ligenten, a gel containing gentamicin, ethonium and lidocaine (as an anesthetic). The trial included 28 females at the age of 20 to 58 years with residual inflammations in the urogenital organs after the completion of the antimicrobial therapy of the urogenital infections. The gel was applied locally as tamponade and/or irrigation of the urethra 1-2 times a day for 6 to 10 days. The results of the treatment showed that the residual inflammations were completely eliminated in 17 out of 26 patients, in 5 patients a significant improvement was stated and in 4 patients the treatment failed. The data indicated that Ligenten is useful in the complex treatment of urogenital infections as a local therapy of residual inflammations.

Ligenten gel is a combined dosage form containing gentamicin (a broad spectrum antibiotic), lidocaine (an anesthetic) and ethonium (an antiseptic). The hydrogel sodium carboxymethylcellulose in combination with polyvinylpyrrolidone is used as the ligenten base. The clinical trials in urologic and gynecologic patients showed that ligenten had a high therapeutic efficacy in the treatment of inflammatory diseases, as well as an anesthetic action in instrumental examinations and surgical endoscopic manipulations.