1. Xanthan gum.
2. Sucrose.
3. Trisodium phosphate.
4. collodion silicon dioxide.
5. Flavoring.

• streptococci;
• golden staphylococcus aureus;
• hemophilic infection;
• moraxels;
• brothels;
• legionella;
• campylobacter;
• gonorrhea stick;
• clostridioses;
• peptostreptococci;
• treponema.

A new type of antibiotic - sumamed, which is used for chlamydia, has become widespread. Throughout the entire therapeutic course, it is necessary to pay maximum attention to the prescriptions of the attending physician. This will allow you to quickly and effectively get rid of the disease, preventing the transition acute stage disease into a chronic one.

Chlamydia is a serious infectious disease genitourinary system both in the male and female population. Chlamydia are bacterial microorganisms that can not only cause an infectious process, but also invade the mucous membranes of the genitourinary system. In addition, chlamydia penetrate the cell structures, overcoming the cell wall, making their way to the very nucleus. When infected with chlamydia, reproductive system susceptible to attacks from pathogenic microorganisms that can cause a secondary infection in the area of ​​​​the pelvic organs.

General information and benefits of sumamed

Sumamed is a broad-spectrum antibiotic. It belongs to azalide macrolides. The active ingredient of the drug is azithromycin. As auxiliary substances are:

1. Xanthan gum.
2. Sucrose.
3. Trisodium phosphate.
4. collodion silicon dioxide.
5. Flavoring.

The drug is produced in the form of capsules and powder for suspension. Capsules are prescribed for adult patients, and a special syrup is used for children.

This type of antibiotic is innovative in the field of pharmacology. The fact is that in the treatment of an infectious lesion caused by chlamydia, it is necessary to take into account the factor that the bacterium is able to penetrate the cell. That is why not all antimicrobial agents are suitable for treatment. The advantage of sumamed is that it is able to penetrate into cellular structures, inhibiting the synthesis of protein components in a bacterial microorganism, thereby leading to its death. In addition to chlamydia, other types of pathogenic microflora are sensitive to azithromycin, the basic active ingredient in the preparation:

• streptococci;
• golden staphylococcus aureus;
• hemophilic infection;
• moraxels;
• brothels;
• legionella;
• campylobacter;
• gonorrhea stick;
• clostridioses;
• peptostreptococci;
• treponema.

Despite the large spectrum of action, Sumamed does not have a pronounced activity against Gram-positive bacteria resistant to erythromycin.

The antibiotic sumamed has an excellent ability to penetrate the mucous membrane, and the concentration of azithromycin in the lesion remains for a week after taking the last dose of the drug. This effect causes the medication to be taken in short therapeutic courses, lasting from 3 to 5 days. The effectiveness of sumamed is expressed in relation to gonococcal infection and pale treponema. This makes it possible to treat gonorrheal-chlamydial infections with this antibiotic, as well as when chlamydia is combined with the early stages of syphilis.

Treatment of chlamydia with sumamed: how to take, dosage

A new type of antibiotic - sumamed, which is used for chlamydia, has become widespread. Throughout the entire therapeutic course, it is necessary to pay maximum attention to the prescriptions of the attending physician. This will allow you to quickly and effectively get rid of the disease, preventing the transition of the acute stage of the disease to the chronic one.

Chlamydia is a serious infectious disease of the genitourinary system, both in the male and female population. Chlamydia are bacterial microorganisms that can not only cause an infectious process, but also invade the mucous membranes of the genitourinary system. In addition, chlamydia penetrate the cell structures, overcoming the cell wall, making their way to the very nucleus. When infected with chlamydia, the reproductive system is susceptible to attacks from pathogenic microorganisms that can cause a secondary infection in the area of ​​​​the pelvic organs.

General information and benefits of sumamed

Sumamed is a broad-spectrum antibiotic. It belongs to azalide macrolides. The active ingredient of the drug is azithromycin. As auxiliary substances are:

1. Xanthan gum.
2. Sucrose.
3. Trisodium phosphate.
4. collodion silicon dioxide.
5. Flavoring.

The drug is produced in the form of capsules and powder for suspension. Capsules are prescribed for adult patients, and a special syrup is used for children.

This type of antibiotic is innovative in the field of pharmacology. The fact is that in the treatment of an infectious lesion caused by chlamydia, it is necessary to take into account the factor that the bacterium is able to penetrate the cell. That is why not all antimicrobial agents are suitable for treatment. The advantage of sumamed is that it is able to penetrate into cellular structures, inhibiting the synthesis of protein components in a bacterial microorganism, thereby leading to its death. In addition to chlamydia, other types of pathogenic microflora are sensitive to azithromycin, the basic active ingredient in the preparation:

• streptococci;
• golden staphylococcus aureus;
• hemophilic infection;
• moraxels;
• brothels;
• legionella;
• campylobacter;
• gonorrhea stick;
• clostridioses;
• peptostreptococci;
• treponema.

Despite the large spectrum of action, Sumamed does not have a pronounced activity against Gram-positive bacteria resistant to erythromycin.

The antibiotic sumamed has an excellent ability to penetrate the mucous membrane, and the concentration of azithromycin in the lesion remains for a week after taking the last dose of the drug. This effect causes the medication to be taken in short therapeutic courses, lasting from 3 to 5 days. The effectiveness of sumamed is expressed in relation to gonococcal infection and pale treponema. This makes it possible to treat gonorrheal-chlamydial infections with this antibiotic, as well as when chlamydia is combined with the early stages of syphilis.

chlamydia. has anyone recovered?

Girls, they found chlamydia in me. The doctor says that the treatment is very difficult and long. I have a question, who had this muck, how long did it take you to cure it? appears again? And how expensive was it all. how long after treatment can i get pregnant? we wanted a baby so much. and will have to be postponed indefinitely, very sorry. well, at least before that we went to be examined.

She was cured the second time with a lethal dose of antibiotics. I read that one pill can be treated, but when I said this to my doctor, she laughed. I didn’t check this one pill and decided to follow the instructions from the first doctor; I thought I wouldn’t be able to do it with a weight of 48 kg, they injected two bottles of phycloferon, the nurses’ eyes bulged, they say, where so much. Of course, I was afraid that I would completely die, but I continued to believe the doctor and pierced everything according to the scheme. V overall result I’m happy to the point of madness for rubbish. If anyone is interested, I can send a diagram. When I put up the scheme on the Internet, other doctors recommended changing the doctor to an adequate one, but I didn’t have anyone to change, and I stayed with her. the fact remains cured. Health to all.

The doctors were right - it was necessary first to take a closer look at this virus, the tests that detect it, do them, get acquainted with the group of macrolides that were invented specifically for trash, fill the doctor's face and not change! and only then uzhde look for adequate! I wish you "do not die" from the consequences of antibiotic therapy "adequate"! For the future, carefully study articles on the topic of dysbiosis and pathogenic intestinal flora on the mucous membranes of the body!

How to take sumamed for chlamydia: treatment regimen, dosage

A huge variety of drugs of the antibacterial group suggests the absence of difficulties in treatment, however, as shown medical practice, tetracyclines or macrolides are most often prescribed, in particular - sumamed. However, doctors say that in order for the medication for chlamydia to be most effective, it must meet the following requirements:

• Microbiological activity - 95% or more
• Efficacy not only against the symptoms of the disease, but also when taken with its asymptomatic course
• The minimum number of contraindications, including the admissibility of use in pregnant women
• The most simplified treatment regimen (ideally - a single dose of the appropriate dosage)
• No need to change the patient's lifestyle
• Minimum possible side effects
• Affordable price
• The ability in the treatment of chlamydia with sumamed to simultaneously affect other urogenital infections

Unfortunately, despite the fact that Sumamed in the treatment of chlamydia meets most of these requirements, but not all. That is why it cannot be said that it is the best remedy from chlamydia, but nevertheless - the most preferable. However, the most valuable property of this drug is certainly considered to be that sumamed with chlamydia can help even with its single use, which significantly reduces the likelihood of side effects and other unpleasant phenomena.

Summed for chlamydia: dosage and regimen

The biggest problem successful treatment urogenital infections has been and remains an urgent need to comply with the scheme prescribed by the doctor. For example, a course designed for 7 days may not be beneficial even if a person misses a dose of medication on day 6. Unfortunately, this leads to the need for a second course or even the appointment of another drug. The treatment regimen for chlamydia with sumamed, at the same time, implies a single dose (in the vast majority of cases), i.e. There is no chance of missing from the start.

However, this does not mean that with an established diagnosis, you can independently purchase and start using sumamed - chlamydia will not necessarily be eliminated, but many problems may not be avoided. This is explained by different dosages, therefore, no one except the doctor can tell how to take sumamed for chlamydia, and this is done only after complete examination and making an accurate diagnosis. For the convenience of patients, the drug is available in several forms and dosages, which allows you to choose the optimal therapy regimen for everyone, including children and pregnant women.

It became possible for the first time to treat chlamydia with a single dose of antibiotics when Sumamed appeared on the pharmaceutical market. At the same time, doctors argue that the effectiveness of such a scheme is identical to the seven-day course of treatment with doxycycline, and the number of possible side effects and contraindications is incomparably less. In advanced cases, it is allowed to take the recommended dosage three times, while due to the fact that the concentration sufficient for therapeutic effect, persists for a week, the scheme consists in the use of one tablet of sumamed in 7 days, three times. The dosage in this case, as in any other situations where treatment of urogenital infections is necessary, is selected for each patient individually.

Sumamed is prescribed for infectious and inflammatory processes respiratory tract and ENT organs: including pneumonia, and others.

In addition, Sumamed can be prescribed for Lyme disease, borreliosis, erythema and some other diseases. It is available in the form of tablets, suspensions or capsules, in all cases it is necessary to follow the instructions and correctly calculate the dosage.

In addition, Sumamed is prescribed for infectious skin diseases and inflammatory processes: including acne, erysipelas, dermatosis and many other skin problems.

Broad-spectrum antibiotics can only be prescribed by a doctor: uncontrolled use can lead to a decrease in their effectiveness and numerous side effects.

Sumamed, like any potent drug, has a number of absolute contraindications. It is not prescribed in the following cases:

• During lactation. Contraindication is age up to 6 months, in more late dates suspension may be prescribed. From the age of three, tablets with a dosage of 125 mg can be prescribed; from the age of 12, the dosage of tablets increases to 450 mg.
• During the period, Sumamed is not prescribed if there is no serious threat to the health of the mother. However, it is recommended as the main remedy for the fight against some venereal infections.
• Contraindication is a violation of the kidneys and liver. Active substance long enough to be excreted from the body, and most of it is removed with urine. Renal failure prevents this, so the drug is not prescribed.
• The use of Sumamed is not recommended for diabetes, disorders of the heart: arrhythmias, heart failure, etc.

In addition, there are restrictions on the use in conjunction with other drugs. With digoxin and terfenadine, it is not prescribed at all, in all cases only a doctor can prescribe the correct course of treatment.

Rules for taking Sumamed for adults

Sumamed - dosage for adults

How to take Sumamed? The dosage and method of administration depend on the age of the patient and some other parameters. In all cases, the medicine is taken 1 time per day an hour before a meal or an hour after it.

Tablets and capsules are prescribed for adults, the standard dosage for a patient over 12 years old and weighing more than 45 kg is 500 mg.

The course of treatment depends on the disease:

• At infectious diseases respiratory tract and ENT organs is prescribed 500 mg of the drug per day 1 time per day. The course of treatment takes 3 days. After that, the doctor will evaluate the changes in the patient's condition and decide on the further use of antibiotics.
• In Lyme disease, a 5-day course of treatment is prescribed: on the first day, you need to take 1 g of the drug, on the remaining days the dose is halved. The total dose taken by the patient should not exceed 3 g.
• With and 1 time per day, 500 mg of the drug is taken.
• During treatment skin diseases and acne the course of treatment will be longer. In the first three days, the patient should take 500 mg of the drug once a day, then 500 mg once a week for 9 weeks. The drug is taken strictly every 7 days.
• For urethritis and other infectious and inflammatory processes in the urinary tract, an antibiotic is prescribed 1 time in an amount of 1 gram. This is only part of the course of treatment, it is necessary to follow all the recommendations of specialists.

This information is advisory in nature. Depending on the course of the disease and the characteristics of the patient's body, the dosage varies, it is prescribed by the attending physician. In order to prevent serious side effects, you can not independently purchase and use the drug even on the basis of medical recommendations in the instructions.

Rules for taking Sumamed for children

Sumamed - dosage for children

For children, the method of application and possible dosage depend on age and body weight: for children weighing less than 45 kg under the age of 12 years, the dosage is 10 mg per kilogram of weight. In infectious diseases of the respiratory tract and ENT organs, the course of treatment is usually 3 days, the drug in a precisely calculated dose is used 1 time per day.

With Lyme disease, the course of treatment takes 5 days: on the first day, the medicine is taken at the rate of 20 mg / kg, from 2 to 5 days it is halved.

Thus, the total amount of antibiotic taken should not exceed 60 mg per kg of the child's weight.

Usually, children are prescribed tablets and capsules, the dosage of which is 125 g. Depending on the weight of the child, the doctor will prescribe 2 or 3 tablets.

For young children under the age of 3 years, the dosage is calculated in the same way:

• In the treatment of infections, a 3-day course will be prescribed with the calculation of 10 mg of the drug per kilogram of weight, the treatment for tonsillitis and other diseases provoked by streptococci will be similar.
• In Lyme disease, a 5-day course will be prescribed according to the above scheme, the total dosage during the entire course of treatment should not exceed 60 mg / kg.
• Small children are not prescribed tablets, but a suspension, it must be thoroughly mixed and brought to a homogeneous consistency.

Video on how to prepare the Sumamed suspension.

Balm "Asterisk": composition, properties and rules of use

An overdose in the treatment of children is completely unacceptable, therefore, it is impossible to violate the terms of treatment and the schedule prescribed by the doctor. It is not uncommon for parents to try to speed up recovery and increase the dose for this. This will not only not help the child, but can lead to a serious deterioration in well-being.

Parents are advised to keep a diary in which all medications taken and their actions should be recorded. If any signs of allergy and individual intolerance appear, the doctor will select other drugs, and keeping a diary will greatly facilitate his work. In addition, it will allow you to note positive changes in well-being.

Possible side effects

When taking Sumamed, some negative side effects are possible due to the pharmacological action of the drug.

They can manifest themselves depending on the characteristics of the body, the most common are the following phenomena:

• Digestive system. Perhaps the appearance of pain in the abdomen, nausea and vomiting, symptoms of gastritis, bloating. With prolonged use or uncontrolled use, drug-induced hepatitis, severe liver dysfunction are possible.
• Nervous system. Sleep disturbances, increased fatigue, dizziness, as well as impaired smell and touch are possible. In the treatment of otitis in children, a side effect of Sumamed can be a headache.
• With individual intolerance to the components of the drug, severe allergic reactions are possible: Quincke's edema, increased sensitivity to light, skin rashes, itching, rash.
• : possible heart palpitations. If you already had heart problems, an exacerbation of chronic diseases is possible.

Side effects are not often manifested: they may be associated with individual sensitivity to the components of the drug. If any allergic reactions to antibiotics have already been observed before, this should be reported to a specialist.

A solid list of side effects partly confirms the effectiveness of the drug: a potent substance affects all organs and systems, so it is so important to strictly follow the instructions and prescribe an antibiotic only when it is really necessary.

P Prolonged use may cause serious malfunctions digestive system.

The antibiotic destroys the beneficial intestinal microflora, which can cause dysbacteriosis and require special treatment.An overdose is manifested by symptoms of poisoning: nausea, vomiting, stool disorders, in addition, temporary hearing loss is possible. Special is not required, it is enough to relieve symptoms.

Sumamed - effective antibiotic, which allows you to fight various infections and get a quick result, new drug proved to be excellent, and it is provided with wide application.

Sumamed for chlamydia is used in the treatment of acute and chronic forms of infection provoked by microorganisms and Chlamydia pneumoniae. The drug is an antibiotic of the group of macrolides-azalides. pharmachologic effect it provides an active ingredient that stops the growth and reproduction of pathogenic bacteria by suppressing protein synthesis inside their cells.

Dosage forms and composition

A variety of drug forms of Sumamed allows doctors to use it in the treatment of chlamydia in patients of all age groups. The drug is produced in the form:

• tablets;
• capsules;
• powder for oral suspension.

Tablets and capsules are used in the treatment chlamydial infection in adults and children school age. The fight against infection in young patients is carried out using a suspension.

The tablet form of the drug is available in the form of film-coated pills of blue color with a bevel. Tablets are placed in contour cell plates of 3 and 6 pieces. Each carton contains one plate of medicine.

Sumamed capsules have a hard body made of blue-white gelatin. content dosage form is a white or light yellow powder. Capsules are packed in 6 pieces in blisters, each of which is placed in a separate cardboard box.

The powder is produced in the form of white or light yellow granules, which, after dissolving in water, turn into a homogeneous suspension with a fruit and berry aroma. The powder is contained in 50 ml vials. Vials are individually packed in carton boxes and are additionally equipped with a measuring spoon or a dosed syringe.

The active substance of all drug forms of the drug is azithromycin dihydrate. Its mass content in a tablet is 125 or 500 mg, in a capsule - 250 mg, in 5 ml of suspension - 100 mg.

How does it work on chlamydia

Sumamed - antibacterial agent, which is used in the treatment of chlamydia, sexually transmitted and airborne. When ingested, azithromycin is rapidly absorbed from the digestive system and is evenly distributed throughout all tissues and body fluids in the body. A feature of the active component is its ability to concentrate not in blood plasma, but in cells affected by chlamydial infection. This reduces the negative impact of the drug on the heart, liver and spleen.

The half-life of azithromycin from blood serum is 40 hours, from infected cells - 60 hours. The substance is excreted unchanged from the body mainly through the intestines. A small part of it (about 6-12%) is excreted through the urinary tract.

Method of application for chlamydia

Treatment of chlamydia with Sumamed is carried out after laboratory confirmation of infection in a patient. The choice of drug form of the drug depends on the age and body weight of the patient.

In the stomach filled with food, the absorption of azithromycin slows down, so the drug is recommended to be taken 1 hour before a meal or 2 hours after it is completed. Tablets and capsules are taken as a whole, without chewing and drinking the required amount of water. Before use, the suspension should be measured with a spoon or syringe and swallowed with water or juice.

When using Sumamed for chlamydia, the treatment regimen should be determined by the doctor. When compiling it, the specialist takes into account the stage of the disease and the presence of comorbidities in the patient. At acute form chlamydial infection, azithromycin is prescribed simultaneously with probiotics and hepatoprotectors. Treatment of chronic chlamydia is usually carried out by taking Sumamed in parallel with hepatoprotectors, cardioprotectors, immunostimulants, probiotics and some other groups of drugs.

During treatment, the patient must remember that the use of the drug in an inadequate dose or according to the wrong scheme will not bring the expected recovery. To ensure the success of antibiotic therapy, the patient is recommended to undergo a re-examination for chlamydia a few weeks after its completion.

Contraindications

Before taking Sumamed, the patient needs to familiarize himself with the list of contraindications to it. You should not take this remedy for people suffering from:

• hypersensitivity to its constituent components;
• individual intolerance to macrolides or ketolides;
• kidney or liver failure.

Each drug form of Sumamed has its own age restrictions in use. Do not use 500 mg tablets and 250 mg capsules in the treatment of chlamydia in children under 12 years of age. Taking the tablet form of the drug with a dosage of azithromycin 125 mg is contraindicated in patients under 3 years of age. Sumamed oral suspension, obtained from powder, is forbidden to be given to babies under 6 months of age.

There is no information on the safety of using Sumamed during pregnancy, so it should be prescribed to women during the period of bearing a child only if absolutely necessary. Azithromycin is found in breast milk, however, its effect on the body of newborns has not been adequately studied. In this regard, it is necessary to prescribe Sumamed from chlamydia to nursing mothers with caution.

Undesirable consequences from taking

During the use of azithromycin, people may experience side effects from different systems and organs. The list of common antibiotic side effects includes:

Medical practice knows cases of acute kidney failure, insomnia, dizziness, hallucinations, convulsive syndrome, fainting, visual and hearing disorders, internal bleeding, changes in the composition of the blood, etc. If any unwanted effects from therapy, the patient should visit a doctor.

Sumamed can provoke dizziness, drowsiness and other symptoms in a person that affect the ability to concentrate. In this regard, patients who drive vehicles or work with potentially dangerous mechanisms should refrain from performing the described activities for the entire period of treatment for chlamydial infection.

Purchase method and cost

You can buy Sumamed at the pharmacy with a prescription. average price a pack of 125 mg tablets is 330 rubles, 500 mg tablets - 440 rubles per pack. For the original packaging with Sumamed capsules, the patient will have to pay about 420 rubles, for a bottle of powder for preparing a suspension - 210 rubles.

Patient evaluation

Patients who had to treat chlamydia with Sumamed leave positive feedback about this antibiotic. The use of the drug in accordance with the treatment regimen drawn up by the doctor allows you to get rid of chlamydia in 1 treatment course. Adverse reactions, developing during therapy, in most patients are mild and disappear shortly after the end of the antibiotic.

Chlamydia (Chlamydial infection) throughout its treatment requires careful attention to certain properties of chlamydia, which help to cope with the disease.

What should antibiotics be?

In other words, any drug must have the ability to penetrate the cell body and fight the virus there.

Important! Together with chlamydia, the genitals are also attacked by other microorganisms that can cause inflammatory processes in the pelvic organs and genitals.

Given that together with chlamydia, an attached infection can also occur, antibiotics are prescribed, which will equally negatively affect all possible infections.

Now in medicine, three main groups of antibiotics are used to treat chlamydia:

• Tetracyclines.
• Macrolides.
• Fluoroquinolones.

All other drugs do not have sufficient ability to suppress the infection, in addition, they can, on the contrary, lead to the fact that the infection will remain in the same position, and even become resistant to drugs. The drugs are equally suitable if it is chlamydia in women, or in men, there is no difference in action.

How to take tetracyclines

In addition to tetracycline, doxycycline can also be attributed to this genus of antibiotics.

The drugs do an excellent job if the chlamydial infection is not running and is not complicated.

Tetracycline is taken 4 times a day, at a dose of 400 mg. The course is calculated for 7-15 days.

Doxycycline is taken 2 times a day, and the dosage is determined at the level of 100 mg

The course of taking macrolides

Here is a list of funds that you can take much more, and among them it is worth noting:

• Rovamycin.
• Klacid.
• Macrofoam.
• Wilprafen.
• Erythromycin.

Erythromycin is one of the most commonly used antibiotics in this series, but it can sometimes be difficult to tolerate by the body.

Rovamycin, unlike erythromycin, is a much more “calm” and safe antibiotic.

It has the ability to accumulate in a high concentration in the focus of inflammation, and a much lower toxic effect. In this regard, the drug is tolerated by the body easier and without complications and side effects.

Sumamed's reception

Sumamed already after the first dose reaches the maximum concentration of the antibiotic in the focus of inflammation, and remains at the same high level concentrations over the next 5 days.

To some extent, there is no remedy for chlamydia better than sumamed, especially considering that gonococcus also dies under its influence.

On the other hand, if you answer a simple question - then this treatment will not be required, but this is already a theory, and we need practice.

Such properties of the drug allow it to be used in more a wide range, including with gonorrheal chlamydia, and even with early stages syphilis.

Taking sumamed is somewhat complicated by the sequence:

• The first dose is taken one hour before a meal, or two hours after.
• The course lasts 7 days.
• The dosage is 500 mg of the drug.
• A dosage of 250 mg suggests a course of 10-14 days, according to the same regimen.

Important! Unfortunately sumamed can't handle aerobic infection genus Bacteroides, and this point can be attributed to the obvious shortcomings of the drug, which is still more narrowly targeted.

Klacid against chlamydia

The course is designed for two weeks, the dose is 250 mg, taken twice a day.

It is necessary to take drugs strictly according to the recommendations, since the treatment of chlamydial infection can also affect other diseases, for example, it depends on it and which will not be complete without chlamydia therapy.

Conclusion

Today in medicine there are a large number of antibiotics that successfully counteract chlamydia. And along with take off can be used very effectively.

In this case, the treatment must be prescribed by a doctor, as well as prescribing an antibiotic. Remember that treatment should always be carried out only on the basis of a correct diagnosis!

Catad_tema Chlamydia - articles

Issues of gynecology, obstetrics and perinatology, 2003, vol. 2, no. 3, p. 81-84

D.D.Belotserkovtseva 1 , P.V.Budanov 2
1 Surgut State University;
2 Moscow medical Academy them. I.M. Sechenov

One of the most urgent problems of modern clinical medicine is infections with intracellular persistence of the pathogen. Despite the extensive study of chlamydial infection, the high incidence of complications, recurrence and treatment failure dictates the need to develop new approaches to the treatment of this pathology.

Representatives of the genus Chlamydia, which includes the only species pathogenic for humans - Chlamydia trachomatis, contain extrachromosomal elements similar in ultrastructure. Elementary bodies of representatives of this genus, having penetrated into a living cell, have a tendency to merge into one common inclusion, which leads to the exchange of genetic information and causes a large genetic variability of the pathogen.

Like N. gonorrhoeae, C. trachomatis is characterized by tropism for columnar epithelium.

Elementary bodies (EB) of chlamydia are oval in shape with a size of 250-500 nm. They have infectious, antigenic properties, are able to penetrate into sensitive cells. Chlamydia's unique cycle of development occurs only within the cell's membrane-bound cytoplasmic vacuoles, where elementary bodies transform into larger reticular bodies that undergo division.

Reticular bodies (RT) have polymorphism (round, oval, crescent, coccobacillary shape), do not have a constant size and structure, and their size ranges from 300 to 1000 nm. Reticular bodies do not have infectious properties, do not have a nucleotide, and belong to the vegetative (“immature”) forms of the pathogen.

The first stage of the infectious process is the adsorption of Chlamydia ET on the cell membrane of a sensitive host cell under the action of electrostatic forces. C. trachomatis has a tropism for the defeat of the cylindrical epithelium (rarely, in special conditions - peritoneal mesothelium and stratified squamous non-keratinized epithelium). Knowing the localization of the cylindrical epithelium in the organs of the genitourinary system, one can assume the most frequent topical localizations of chlamydia: cervicitis, urethritis, cystitis, endometritis, salpingitis, bartholinitis, lesions of the anorectal region.

Then there is the introduction of chlamydia into the cell by invagination of sections of the plasmalemma and the formation of phagocytic vacuoles (endocytosis). This stage lasts from 7 to 10 hours.

The transformation of virulent EBs into metabolically active vegetative intracellular forms - RT occurs within 6-8 hours. In the process of growth and division, RTs form microcolonies, which are called chlamydial inclusions - "Halberstadter-Prowachek bodies". Microcolonies can contain from 100 to 500 chlamydia.

The process of transformation of RT into ET takes 36-42 hours. At this stage, transitional (intermediate) chlamydia bodies are detected.

The life cycle of chlamydia ends with the release of ET from the endosome and the destruction of the infected cell. However, it is possible to preserve the viability of the infected cell during the release of ET by exocytosis. This is observed in the asymptomatic course of chlamydial infection. After 48-72 hours, the released EBs penetrate into new target cells.

The most important point is that during the primary invasion of the pathogen, the full cycle of development of chlamydia takes about 100 hours (4 days). However, if unfavorable biochemical conditions occur (for example, under conditions of ongoing antibiotic therapy), the duration of the life cycle of chlamydia development can significantly increase, reaching several weeks. In this case, there is a form of latent infection with periodic recurrence and chronic chlamydia.

The second important aspect of the pathogenesis of chlamydial infection is the effect of chlamydia on the processes of immunity. The leading role in protection against chlamydial infection belongs to T-helpers, which activate the phagocytic activity of macrophages. At the same time, polyclonal activation of B-lymphocytes leads to an increase in the production of immunoglobulins of classes M, A and G.

The absorption of chlamydia by peripheral blood monocytes leads to their dissemination throughout the body. Monocytes, settling in the tissues of the joints, blood vessels, heart, turn into tissue macrophages, which remain viable for several months. Local antigenic stimulation leads to the formation of fibrous granulomas in healthy tissue. The release of chlamydia leads to the formation of specific antibodies, even in the absence of chlamydial antigen in the area of ​​the entry gate of infection.

By clinical course emit fresh urogenital chlamydia (disease duration less than 2 months) and chronic (more than 2 months). Fresh urogenital chlamydia is divided into acute, subacute and torpid stages.

Primary infection with Chlamydia trachomatis is almost impossible to detect. In this regard, the division of chlamydial infection into acute, chronic and torpid forms is very conditional.

The clinical manifestation of the disease, as a rule, is present in the presence of a mixed infection or against the background of a decrease in local or general reactivity of the organism. In this case, it is the associated pathogens that determine the clinical manifestations of the disease.

The formation of a clinical diagnosis can only be based on the results of a comprehensive clinical and laboratory examination. It is mandatory to isolate pathogens (etiology), determine the topic of the lesion and associated complications.

Thus, the features of the infectious process, asymptomatic clinical manifestations, the possibility of chlamydia persistence in viable cells, the difficulty of controlling the cure of the infection, dictate the need to select etiotropic treatment regimens for the disease that have high microbiological efficiency, satisfactory compliance, and high bioavailability.

One of the drugs of choice for the treatment of chlamydial urogenital infection in women is azithromycin (Sumamed). At the same time, defects in the immune response that occur against the background of chlamydia require a combination of an antibiotic with immunocorrective drugs.

Currently available immunocorrectors do not have specific action to the activation of local immunity. Their unreasonable use (absence clinical signs immunodeficiency, persistence of infection) can provoke a hyperimmune reaction, which will lead to a deepening of existing disorders, since the vascular bed and tissues of the reproductive organs have hypersensitivity to immune complexes, products of inflammation.

Excessive stimulation of T-lymphocytes provokes autoimmune processes. Hyperactivation of B-lymphocytes stimulates increased production of immunoglobulins, an increase in the concentration of antigen-antibody complexes, which leads to blocking of phagocytes and damage to microcapillaries. Excessive stimulation of macrophages and neutrophils can be realized in an increase in the release of interleukins, monoamines, tumor necrosis factor, which initiates cell damage and reduces the ability of phagocytes to inactivate immune complexes.

In this case, the activated state immune system can be dangerous for the body, and the use of highly active immunomodulatory drugs will be harmful.

Thus, active immunostimulatory therapy is indicated only for patients with clinical manifestations of immunodeficiency and long-term persistent genital infection.

However, in last years preparations of recombinant interferon a-2b (viferon, kipferon, realdiron, intron-A) are widely used. It should be noted that the domestic drug Viferon is intended for rectal administration (or local use). Interferons have a non-specific action that prevents the intracellular assembly of foreign proteins.

The present study included 143 women with fresh uncomplicated chlamydia and 189 patients with a disease duration of more than 4 months. All women were excluded from other sexually transmitted infections.

The use of azithromycin (Sumamed) for the treatment of chlamydial infection in gynecological practice

The detection of absolutely pathogenic microorganisms of chlamydia in all cases requires specific therapy. In this regard, even with the so-called persistence of infection and the absence of clinical manifestations of the disease, treatment is necessary. Each group of patients was divided into two subgroups depending on the treatment option.

With fresh uncomplicated urogenital chlamydia, 92 women received 1.0 g of azithromycin (Sumamed) orally once (2 tablets of 500 mg). 51 patients were prescribed Sumamed 500 mg (1 tablet) per day for 3 days. Simultaneously with antibiotic therapy, interferon therapy was performed in the form of rectal suppositories containing 150,000 IU of interferon-a 3 times a day for 10 days.

In the presence of chronic chlamydia (persistence of infection), a comparison was made between continuous intake (46 patients) and “pulse therapy” (143 patients) with azithromycin (Sumamed) in combination with an interferon preparation (500,000 IU 2 times a day per rectum for 5 days - 3 courses with an interval of 5 days). The course of treatment included taking 1.0 g (2 tablets of 500 mg) of azithromycin (Sumamed) orally on the 1-7-14th day of treatment or 500 mg (1 tablet) of the drug 1 time per day for 3 days three times with an interval of 5 days.

Similar treatment was given to the sexual partners of the women included in the study.

Neither of modern methods diagnosis of chlamydia is not 100% reliable. So laboratory diagnostics should be based on a combination of at least two methods, one of which should be cultural. Diagnosis of chlamydial infection was carried out by isolating the pathogen in a McCoy cell culture, amplifying homologous DNA regions using a polymerase chain reaction on a Tertsik apparatus, and the HlaMonoScreen kit (Nearmedic, Russia) was used for direct immunofluorescence reaction.

Polymerase chain reaction (PCR) has advantages over immunological methods:

• high specificity - 95%;
• maximum sensitivity;
• speed of conduct (4-5 hours).

The disadvantage of PCR diagnostics of chlamydia is the possible false positive results when conducting a study earlier than a month after the end of the course of treatment. This is due to the fact that the DNA/RNA amplification method does not allow assessing cell viability and gives positive results with small amounts of the pathogen and the presence of individual fragments of its genome. In spite of this primary way evaluation of chlamydia elimination should be PCR. Upon receipt of a positive result, a microbiological research, and if the latter is impossible, repeat PCR after 5-6 weeks.

Thus, in this work, it was assumed that the most reliable method diagnosis of chlamydia is a combination of culture and polymerase chain reaction. The material for the study was the discharge cervical canal, urine, contents abdominal cavity and cavities of the internal genital organs.

Rice. one.
Scheme for monitoring the effectiveness of therapy for urogenital chlamydia.

Topical diagnostics various forms chlamydia was carried out on the basis of clinical examination, extended colposcopy, ultrasound, laparoscopy.

To control the effectiveness of therapy, the following scheme was used (Fig. 1).

After receiving data on the microbiological efficacy of the treatment (71.1%), 236 of all patients remained under our supervision for 18 months. With an interval of 6 months, they underwent a control laboratory examination, which included a combination of the cultural method for identifying chlamydia and polymerase chain reaction.

As a result of the study, it was found that in the group of women with uncomplicated fresh chlamydia, the maximum effectiveness of therapy reached 93%. At the same time, the indicators of the microbiological and clinical efficacy of the therapy performed did not differ significantly throughout the entire observation period (18 months).

It was noted that out of 92 patients of the first subgroup, only one did not fulfill the conditions for taking Sumamed, taking the drug with meals. Among 56.9% of women in the second subgroup who received an antibiotic for 3 days, fluctuations were observed between the time of taking the drug up to 3.2 ± 0.6 hours. 8 patients (15.7%) did not fulfill the conditions for the use of the antibiotic, having independently stopped taking sumamed.

Eradication of the pathogen was observed in 81.1% of patients by the time of the first laboratory control after treatment, and the disappearance of clinical symptoms in 85.3% of women was achieved by day 14 after the end of therapy.

Among the side effects while taking Sumamed, one woman experienced allergic reaction according to the type of urticaria (in the group with a single dose of an antibiotic), and in 4 (7.8%) patients out of 51 who took Sumamed for 3 days, diarrhea was noted during the week.

Rice. 2.
Clinical and microbiological efficacy of Su-mamed for the treatment of urogenital chlamydia.

The most significant differences in the effectiveness of therapy and patient compliance with the rules, regimen and duration of drug intake were noted in the treatment of persistent chlamydial infection.

Thus, the microbiological and clinical efficacy of various treatment options for urogenital chlamydia is shown in Fig. 2.

As seen in fig. 2, indicators of microbiological and clinical efficacy in the treatment of persistent chlamydia reached their maximum values ​​by 4 weeks after the end of treatment. Only during the first control clinical efficacy prevailed over microbiological. For 1.5 years, the effectiveness of therapy for urogenital chlamydial infection after using Sumamed "pulse therapy" decreases slightly.

At the same time, when using other antibiotic regimens, the frequency of elimination of the pathogen is less common than clinical cure, and the effectiveness of therapy does not exceed 82%.

It should also be noted that the highest compliance accompanies the three-time regimen of Sumamed. During the entire treatment period, only 4 patients (2.8%) were excluded from the study: 3 due to non-compliance with the rules for taking the drug and 1 due to an allergic reaction.

Against the background of prolonged Sumamed regimens, the overall incidence of side effects did not exceed 3.7%, while up to 3/4 of them were noted among women who used a continuous regimen of taking the drug.

Thus, azithromycin (Sumamed) is highly effective for the treatment of fresh uncomplicated chlamydia, regardless of the regimen. The regimen with a single dose of the drug is characterized by high compliance, low frequency of adverse reactions.

In the treatment of persistent chlamydial infection, the greatest clinical and microbiological effectiveness, lengthening the time of the relapse-free interval, allows achieving "pulse therapy" with azithromycin (Sumamed), which includes taking 1.0 g of the drug on days 1-7-14 of treatment. The creation of therapeutic concentrations of azithromycin (Sumamed) in infected tissues for 5-7 days after a single oral administration allows to achieve eradication of the pathogen and long-term preservation of the antibacterial effect. If it is necessary to take the drug for a long time, its similar properties determine the possibility of discrete administration of Sumamed, which leads to a decrease in side effects and an increase in compliance with the treatment.

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