Русский
Combined therapy of patients with recurrent cystitis using a complex of natural antimicrobial peptides and cytokines: first results
DOI: https://dx.doi.org/10.18565/urology.2022.6.47-55
E.V. Kulchavenya, A.I. Neymark, A.Yu. Tcukanov, P.S. Plugin, A.B. Neymark, M.V. Razdorskaya.
1) FGBOU VO Novosibirsk State Medical University of Ministry of Health of Russia, Novosibirsk, Russia; 2) Medical Center “Avicenna”, Novosibirsk, Russia; 3) FGBOU VO Altai State Medical University of the Ministry of Health of Russia, Barnaul, Russia; 4) FGBOU VO Omsk State Medical University of the Ministry of Health of Russian Federation, Omsk, Russia; 5) NUZ KB “RJD-Medicine”, Barnaul, Russia
Introduction. Urinary tract infections (UTIs) remain an important problem in urology due to their high prevalence and tendency to relapse. The improvement of the treatment outcomes in chronic cystitis is still relevant.
Material and methods. A total of 91 patients were included in prospective, multicenter, randomized, comparative, controlled study. They were randomized into three groups: in the comparison group 1 (n=32) basic therapy was administered for 5 days. In the comparison group 2 (n=28) basic therapy was combined with rectal suppositories Superlymph® 25 IU once a day for 10 days. In the main group (n=31) basic therapy in combination with rectal suppositories Superlymph® 10 IU once a day for 20 days were prescribed.
The basic therapy included a combination of two antimicrobial drugs: fosfomycin trometamol 3.0 g at night once on the first day of therapy, and furazidin 100 mg three times a day after meals for 5 days. Pathogenetic treatment was not prescribed in comparison group 1, but administered for 10 days and 20 days in comparison group 2 and main group, respectively.
Results. After the completion of etiotropic therapy, a significant effect in all groups was shown. At the same time, at the 2nd visit, there was a significantly better results in patients who received Superlymph® rectal suppositories, both at a dose of 10 U and at a dose of 25 U, without any differences between two schemes. The frequency and severity of cystitis symptoms at the end of etiopathogenetic therapy in the main group was less pronounced than in the comparison groups (p=0.0001), and a significant difference was found between comparison groups 1 and 2 (p=0.0001). The use of Superlymph® significantly improved the parameters of microcirculation in the urethra, however, there was no difference between comparison group 2 and main group.
Conclusion. Etiopathogenetic therapy, including Superlymph® rectal suppositories at a dose of 10 IU and 25 IU in patients with chronic cystitis, can significantly improve the results of combination therapy. Analysis of the symptoms score of acute cystitis showed the superiority of longer-term use of Superlymph® rectal suppositories at a reduced dosage (10 units). Peptide-cytokine therapy led to a significant improvement in local microcirculation in comparison group 2 and the main group.
Material and methods. A total of 91 patients were included in prospective, multicenter, randomized, comparative, controlled study. They were randomized into three groups: in the comparison group 1 (n=32) basic therapy was administered for 5 days. In the comparison group 2 (n=28) basic therapy was combined with rectal suppositories Superlymph® 25 IU once a day for 10 days. In the main group (n=31) basic therapy in combination with rectal suppositories Superlymph® 10 IU once a day for 20 days were prescribed.
The basic therapy included a combination of two antimicrobial drugs: fosfomycin trometamol 3.0 g at night once on the first day of therapy, and furazidin 100 mg three times a day after meals for 5 days. Pathogenetic treatment was not prescribed in comparison group 1, but administered for 10 days and 20 days in comparison group 2 and main group, respectively.
Results. After the completion of etiotropic therapy, a significant effect in all groups was shown. At the same time, at the 2nd visit, there was a significantly better results in patients who received Superlymph® rectal suppositories, both at a dose of 10 U and at a dose of 25 U, without any differences between two schemes. The frequency and severity of cystitis symptoms at the end of etiopathogenetic therapy in the main group was less pronounced than in the comparison groups (p=0.0001), and a significant difference was found between comparison groups 1 and 2 (p=0.0001). The use of Superlymph® significantly improved the parameters of microcirculation in the urethra, however, there was no difference between comparison group 2 and main group.
Conclusion. Etiopathogenetic therapy, including Superlymph® rectal suppositories at a dose of 10 IU and 25 IU in patients with chronic cystitis, can significantly improve the results of combination therapy. Analysis of the symptoms score of acute cystitis showed the superiority of longer-term use of Superlymph® rectal suppositories at a reduced dosage (10 units). Peptide-cytokine therapy led to a significant improvement in local microcirculation in comparison group 2 and the main group.
Keywords: targeted cytokine therapy, Superlymph®, uropathogen, pathogenetic therapy, chronic cystitis, cystitis, treatment
About the Autors
Corresponding author: E.V. Kulchavenya – Ph.D., MD, professor, Chief Researcher at TB Research Institute of Ministry of Health of Russia; Head of the Urologic Department, professor at Department of Tuberculosis of FGBOU VO Novosibirsk State Medical University of Ministry of Health of Russia, Novosibirsk, Russia; e-mail: urotub@yandex.ru
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