Treatment of diseases with key cells in the smear

Key cells in a smear are in most cases an indicator of gardnerellosis. But in the classification of diseases, such a disease does not exist at all. Gardnerellosis can be considered as one of the indicators of bacterial vaginosis. At the same time, other microflora, in addition to lactobacilli, is almost always detected in various proportions.

If the vaginal microflora contains not only activated opportunistic microorganisms (gardnerella, streptococci, staphylococci, etc.), but also pathogenic bacteria that cause sexually transmitted diseases, the diagnosis will sound different regardless of whether the smear contains key cells or not. Depending on the identified pathogen of STD, a diagnosis will be made and appropriate treatment will be prescribed, during which it will be necessary to abstain from sexual intercourse.

There are quite a lot of such diseases and approaches to their treatment may differ significantly, so we will not dwell on them, but will talk about how to treat diseases accompanied only by the appearance of key cells and a certain number of other representatives of opportunistic microflora in a smear, indicating vaginal dysbacteriosis in women or balanoposthitis in men.

The presence of key cells in a smear in women and men does not yet indicate a disease, but does indicate a possible infection. If the tests reveal an increased number of leukocytes, indicating the development of an inflammatory process, treatment should be started immediately after identifying the pathogens.

Antibiotic therapy comes to the fore here. The doctor selects the drugs based on the harmful microflora detected during the tests. In most cases, preference is given to such drugs as Clindomycin (lincosamides) and Metronidazole (imidazole derivative). Several other different drugs have been developed based on clindomycin and metronidazole (Trichopolum, Flagyl, Dalacin, Clindacin, ORnidazole, Tinidazole, etc.), which can be used to treat bacterial vaginosis, as well as some chlamydia, trichomonas vaginitis and some other infectious pathologies.

A mild form of the disease does not require systemic administration of antibacterial agents; in severe pathology, systemic antibiotic therapy is prescribed along with local application of antimicrobial ointments, creams, vaginal tablets and suppositories. But as we know, any antibiotic treatment is a blow not only to harmful, but also to beneficial microflora (lactobacilli) in the vagina. If we take systemic antibiotic therapy, then the intestinal microflora (lacto- and bifidobacteria) also suffers. All this can lead not only to the appearance of unpleasant symptoms in the form of discomfort in the vagina and constipation, but also to the development of various diseases.

After a course of antibiotic therapy aimed at destroying harmful microbes, it is imperative to restore beneficial microflora. This is done with the help of special preparations – probiotics. These can be preparations for systemic use that improve the intestinal microflora and the body as a whole (Lactobacterin, Atsipol, Trilact, Bifidum, etc.) or local agents for normalizing vaginal microflora in the form of vaginal tablets, creams, suppositories (Atsilakt, Vagilak, Laktonorm, Vagisan, etc.).

To improve the body's defenses, weakened by the disease, a woman may be additionally prescribed vitamins and immunostimulants of plant origin.

As for the treatment of gardnerellosis in men and the inflammatory process caused by bacteria (balanoposthitis), antibacterial agents (usually in the form of tablets or creams for local use, less often injection solutions), vitamins and immunostimulants are also used in its treatment. Additionally, hormonal (Prednisolone, Lokoid, Advantan, Elidel, etc.) and non-hormonal (Levomekol, Xeroform Ointment, etc.) anti-inflammatory ointments, treatment of the penis with antiseptics (potassium permanganate, furacilin) and physical therapy are prescribed to help relieve inflammation.

Prescribing probiotics in the case of male gardnerellosis is not particularly practiced. They are prescribed mainly in the case when antibacterial therapy does not give results, which indicates a violation of the body's microflora. Although the implementation of systemic antibiotic therapy in itself speaks in favor of taking drugs that restore the destroyed beneficial intestinal microflora (lacto- and bifidobacteria).

The selection of antibiotics for both female and male gardnerellosis ( if key cells are detected in a smear ) must be approached with particular care. The fact is that gardnerella is rarely found in proud solitude. Often their loneliness is brightened not only by opportunistic bacteria, but also by trichomonads, chlamydia and some other representatives of pathogenic microflora. Violation of microflora can also attract viruses and fungi that have been hidden in the body for a long time.

Such a rich composition of pathogens requires a special approach, which should combine antibacterial, antifungal and antiviral therapy. Complex drugs such as Terzhinan and Klion-D facilitate this task in the therapy of the fairer sex, providing antiprotozoal (active against protozoa: trichomonads, amoebas and others), antibacterial, antifungal and anti-inflammatory action. If we are talking only about gardnerella, cocci and trichomonads, combined therapy with drugs based on metronidazole and clindamycin is usually carried out.

During treatment of diseases associated with disruption of the body's microflora due to the activation of opportunistic and pathogenic bacteria, patients of both sexes are advised to abstain from sexual intercourse, drinking alcoholic beverages, including "low alcohol" and beer, eating spicy and heavy food, and visiting a bathhouse. You will also have to limit physical activity, avoid overly emotional and stressful situations, and reduce the number of cigarettes smoked as much as possible.

Effective medications for gardnerellosis

This part of the text should not be taken as a guide to action, allowing you to prescribe medications yourself. We are happy to provide the reader with information on some frequently prescribed drugs from the category of antibiotics and probiotics, but this does not mean that these drugs will help cure the disease. When prescribing medications, the doctor takes into account not only the test results (what types of bacteria were detected and in what quantities), but also the characteristics of the patient's body, the presence of concomitant pathologies and contraindications, the state of the beneficial microflora of the body.

We provide information about effective drugs for purely informational purposes. Ultimately, the treatment regimen and dosage of drugs should be prescribed by the doctor treating the patient.

"Metronidazole" is an antibacterial drug that is active against both gardnerella and trichomonads, which like to join an existing infection. For the treatment of bacterial vaginosis, the drug can be prescribed both in the form of suppositories and in the form of tablets.

Method of administration and dosage. The preparation in suppositories is inserted into the vagina once a day (1 suppository per procedure, preferably before bedtime).

Most often, local treatment for trichomonads is supplemented by oral administration of Metronidazole tablets. The drug is usually prescribed in a dosage of 250 mg twice a day. Women combine the use of tablets with the use of suppositories.

If anaerobic bacteria are also detected, the dose of Metronidazole is increased to 1000-1500 mg per day.

The course of treatment with any form of the drug should not exceed 10 days, but it can be repeated up to 3 times a year.

Contraindications for use. The main limitation in the use of the drug is considered to be hypersensitivity to the components of the drug. Metronidazole suppositories are intended for the treatment of adult patients, while tablets can be taken by children from 6 years of age.

Doctors can prescribe the drug even to expectant mothers, since it does not have a negative effect on the fetus or the course of pregnancy. But this does not mean that a pregnant woman can prescribe this antibiotic at her own discretion.

During treatment with Metronidazole, you should refrain from breastfeeding, because the medicine gets into breast milk, and with it into the child’s body, which can lead to dysbacteriosis in the baby.

During antibiotic therapy, you should avoid drinking alcohol and taking alcohol-containing medications. Metronidazole interacts with other medications, some of which are considered undesirable, which should also be taken into account when taking other medications.

Side effects. Taking the drug may be accompanied by unpleasant reactions from various organs and systems of the body. The digestive system may react with pain in the epigastrium, nausea, stool disorders, development of reversible pancreatitis, taste disturbances, etc. Allergic rashes, redness, itching may be observed on the skin, anaphylactic reactions are less common.

Symptoms such as headaches, dizziness, convulsions, confusion, hallucinations, and mood swings are also possible. Reversible visual impairment and fever are also possible.

"Dalacin" is a drug based on the antibiotic lincosamide called clindamycin, which is often prescribed when key cells appear in a smear. It is effective against gardnerella, bacteriodes, some strains of mycoplasma, chlamydia and some other pathogens of bacterial vaginosis in women. It is used in the form of capsules for oral administration, vaginal suppositories and cream.

Method of administration and dosage. Doctors prescribe Dalacin C capsules in a dosage of 150 to 450 g per dose, depending on the severity of the pathology. The frequency of taking the medicine is usually 4 times a day.

If chlamydia is detected in the vagina, the drug in the maximum single dose is prescribed at intervals of 6 hours for 14 days.

The duration of treatment for dysbacteriosis is usually determined by the composition of the pathogenic microflora and is established by the attending physician.

Dalacin suppositories are used for 3 days at night. 2 suppositories per procedure. Before use, the suppository is carefully removed from the packaging (foil) and inserted deep into the vagina with or without an applicator.

Vaginal cream "Dalacin" is supplied with three or seven applicators with a piston (for each day of treatment). First, you need to draw the cream into the applicator by screwing it onto the tube with cream and gradually squeezing out its contents so that the applicator piston reaches the stop. Unscrew the applicator, close the tube with a cap.

Lying on your back with your legs spread, insert the applicator deeper into the vagina and squeeze out the cream by pressing the plunger. Throw away the removed applicator without the cream.

The course of treatment lasts 3 or 7 days.

Contraindications for use. The main contraindications to the use of the drug in any form of release are hypersensitivity to lincomycin, clindamycin or any of the components of the drug, as well as a history of colitis (intestinal inflammation) caused by taking antibiotics. Oral administration of the drug is not recommended for children under 1 month, as well as for patients with liver and kidney failure.

During pregnancy, Dalacin can only be used in the 2nd and 3rd trimesters and only as prescribed by a doctor. Vaginal suppositories should be used with caution and without an applicator.

Vaginal cream is approved for use from the age of 18. It, like suppositories, is not used during menstruation.

During treatment with the drug, it is advisable to transfer the child to artificial feeding.

As for sexual activity, it is better to limit it. It is necessary to take into account that the composition of the drug can reduce the strength of latex products used for contraception.

Side effects. The main disadvantage of clindamycin, which is the main active ingredient of the drug "Dalacin", is the destruction of beneficial microflora in the vagina, which leads to the development of fungal infections, and in particular vaginal candidiasis.

Frequently occurring unpleasant symptoms associated with the use of the drug include: headaches and dizziness, respiratory infections and urinary tract infections, nausea, abdominal pain and bowel disorders, rashes and itching on the skin. There are also menstrual irregularities, mild pain in the lower abdomen, heavy vaginal discharge, and the development of pseudomembranous colitis. Use during pregnancy may provoke abnormal labor.

"Terzhinan" - vaginal tablets with a complex effect on the vaginal microflora, which allows to simultaneously fight anaerobic bacteria, including gardnerella, representatives of opportunistic coccal microflora, trichomonads, fungi of the genus Candida. This is a complex drug for the treatment of bacterial vaginosis, trichomonas, fungal or mixed vaginitis, as well as for the prevention of the above pathologies and bacterial complications.

Method of administration and dosage. Oblong tablets should be inserted deep into the vagina before going to bed. They should first be dipped in water for half a minute, which will ensure ease of insertion and rapid dissolution of the medicinal form in the vagina. One tablet is used per procedure.

Insert vaginal tablets in a lying position and do not get up for a quarter of an hour so that the undissolved part of the tablet does not slip out.

Treatment of bacterial vaginitis is carried out for 10 days. If a fungus is detected, the course of treatment is doubled. To prevent infections, it is enough to use the drug for 6 days.

Absolute contraindications to the use of the drug are hypersensitivity to its components and childhood. Expectant mothers can use the drug in the 2nd and 3rd trimesters of pregnancy, although at the insistence of the doctor, the drug is used even in the 1st trimester and during lactation.

Side effects of the drug are limited to allergic reactions in the form of swelling and hyperemia of the mucous membranes, pain, burning and itching in the vagina, skin rash, etc.

"Vagilak" is a drug that normalizes the vaginal microflora by introducing several types of live lactobacilli and thermophilic streptococcus (lactic acid coccus, a useful inhabitant of the internal environment of the female body, promoting the reproduction of lactobacilli). The drug is produced in the form of vaginal capsules. It is prescribed for both bacterial vaginosis and fungal or trichomonas pathologies.

Method of administration and dosage. The drug is usually prescribed 5 days after the start of antibiotics and for some time after the end of antibiotic therapy. The total course of treatment is 10 days.

Insert the capsules into the vagina, pushing them deep inside, once a day before bedtime (1 capsule per day).

The drug can be used simultaneously with antibiotics.

Contraindications for use. The drug is not prescribed for hypersensitivity to its components and the presence of inflamed erosions and acute purulent processes in the vagina. Do not use in pediatrics. The use of the drug is permitted during pregnancy and breastfeeding.

Side effects are limited to hypersensitivity reactions to the composition of the drug, which manifest as burning and redness of the mucous membranes of the genitals.

The detection of key cells in a woman's smear implies an examination of her sexual partner as well. And even if the man's test results are negative, it is advisable to undergo preventive treatment with antibacterial drugs, take immunostimulants and vitamins to strengthen the immune system. The fact is that during the incubation period of the disease, the tests may not show anything suspicious, but this does not mean that the man is not at risk of inflammation of the head of the penis due to the proliferation of bacteria.

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Folk remedies

Women usually treat folk medicine as an opportunity to fight a disease without visiting a gynecologist and his prescriptions. This is a fundamentally wrong attitude to one's health, which can have unpredictable consequences, up to and including reproductive dysfunction, i.e. infertility.

What is vaginal dysbacteriosis? This is a violation of its normal microflora, which ensures women's health. Laboratory tests show modified epithelial cells surrounded by bacteria. But we can diagnose the disease on our own only by its external manifestations - abundant discharge with an unpleasant odor, reminiscent of the "aroma" of rotten fish, burning and itching in the genital area. But the same symptoms can be observed in other diseases, including venereal diseases. So without special laboratory tests, it is impossible to say that we are dealing with more or less harmless gardnerellosis. Key and false key cells in a smear are what will help to reveal the true cause of the symptoms and begin effective treatment of the identified bacterial, viral or fungal pathology.

And when the doctor makes a diagnosis (and before that you will still have to undergo a gynecological examination, which women dislike so much), then you can discuss with him the possibilities of drug and folk treatment. You don’t want to be treated with antibiotics, but your gynecologist insists on it? But there are doctors who adhere to a different theory and other methods of treating such a little-studied and controversial disease as bacterial vaginosis. You can contact them. Perhaps they will support the idea of folk treatment using the methods described below or offer something of their own instead of antibiotic therapy (of course, if we are not talking about an advanced disease with a rich breeding ground for various bacterial microflora and a practically killed immune system).

What does traditional medicine offer us for the treatment of bacterial vaginosis? This is local treatment with baths, douches and tampons, plus internal intake of products that restore the body's microflora and means that strengthen weakened immunity.

As we can see, there is no talk of antibiotics. However, traditional medicine actively uses the antimicrobial, antifungal and antiviral properties of individual plants and products. Here, herbal treatment comes to the fore. The above-described properties are characteristic of oak bark, celandine, bird cherry and juniper fruits, calendula, St. John's wort and some other medicinal herbs and plants. Chamomile, silverweed, sage, aloe, sea buckthorn oil and other herbal remedies are excellent for relieving inflammation and alleviating unpleasant symptoms.

Among products, natural bee honey is famous for its pronounced antimicrobial properties. It also helps to increase immunity, both general and local. The main thing is that a person should not be allergic to bee products.

Now let's move on to specific recipes. What compositions can be recommended for vaginal douching for women whose smears revealed key cells:

• Oak bark decoction: take 1 tbsp of crushed dry raw material for 1 cup of boiling water, keep in a water bath for 10 minutes, then leave in a warm place for another 3-4 hours, strain, cool to a barely warm state and use as directed.
• Infusion of calendula flowers: mix the ingredients in the same proportions, leave the mixture in a warm place for about 4 hours, then strain and cool to the desired temperature.
• Bird cherry fruit decoction: pour 1 tbsp of dried fruit with 2 cups of water, boil for about 25 minutes, cool and strain.
• Warm water with the addition of fresh whey or kefir, as sources of lactobacilli. You can wash yourself with the same composition every day.

In douching compositions, you can combine several herbs with anti-inflammatory, soothing and antimicrobial effects. The following collections can be recommended:

• Chamomile + calendula (make an infusion of 1 tbsp of the mixture and 1 cup of boiling water, keeping the mixture warm for about 30-40 minutes),
• Chamomile + goose cinquefoil (make an infusion from 1-2 tbsp of the herbal mixture and 1 liter of boiling water, leave for 30-35 minutes in a warm place),
• Chamomile + plantain (the method of preparation is similar to the previous recipe).

You can also use multi-component collections:

• Chamomile and walnut leaves (5 tablespoons each), wild mallow and oak bark (2 tablespoons each), sage (3 tablespoons). For 1 liter of boiling water, take an incomplete tablespoon of the herbal mixture and boil over low heat for 30 minutes.
• In the previous recipe, we replace the mallow with St. John's wort and prepare the decoction in the manner described above.
• Coltsfoot and juniper berries (3 tablespoons each), yarrow, horsetail, sweet clover, pear, eucalyptus leaves (2 tablespoons each). Take 2 teaspoons of the mixture per 2 cups of boiling water and leave in a thermos for about 2 hours.
• Viburnum bark, clover flowers, celandine grass, flax seeds. For 1 cup of boiling water, take 1 tbsp of the herbal mixture and leave for half an hour.

The compositions, strained through 2-3 layers of gauze, are used warm (not hot). Douching is usually done twice a day, using 50-200 ml of the medicinal composition per procedure. However, it is better to discuss these points with your doctor.

After each procedure, the syringe must be sterilized (boiled and treated with antiseptic agents), otherwise you cannot expect a good effect from such treatment.

Another way to treat bacterial vaginosis is to use tampons soaked in medicinal compounds. Sea buckthorn oil or aloe juice are used as such compounds. But the latter must first be mixed in equal proportions with olive oil.

Tampons can be used from a pharmacy or prepared independently from cotton wool and gauze. It is better to insert a tampon soaked in a medicinal composition into the vagina every night. Such treatment significantly reduces the intensity of inflammatory symptoms, itching and burning in the vagina.

Baths with decoctions of medicinal herbs do not have such a pronounced therapeutic effect, because during sitz baths the composition does not penetrate deeply to the localization of bacteria. And yet, as an auxiliary method that helps alleviate the condition of patients, it can also be included in the treatment regimen.

What compositions can be used for baths:

• Oak bark decoction. The raw material is first soaked in water for 4 hours, then boiled in the same water for about 10 minutes. The resulting decoction is poured into a bath of warm water.
• Chamomile infusion (you will need 150 g of herb for a bath).
• A decoction of walnut leaves (250 g of raw material).
• Herbal collection: walnut leaves, juniper berries, oak bark, chamomile herb. You can also add some oat straw. Pour water over the collection (for 3 tablespoons of the collection, take 2 cups of water), boil for 45-50 minutes, strain and pour into the bath.
• As an option for those who are not allergic to bee products, you can make honey baths (2 tablespoons of honey per 0.5 l of warm water, dissolve and pour into the bath).

Baths can be done before inserting tampons with herbal compositions or as a preparation for traditional treatment (suppositories, vaginal tablets, ointments). For 1 bath, about 4 liters of water are usually required, in which the prepared composition is dissolved. The water temperature in the bath should be within 36-37 degrees. The course of treatment includes 7 to 10 procedures lasting at least 15 minutes.

But since the main predisposing factor for the proliferation of bacteria and the appearance of key cells in the smear is still considered to be reduced immunity, to obtain lasting results, it will be necessary to take internally compositions of herbs and plants that are immunostimulants. Such plants include echinacea, eleutherococcus, ginseng, magnolia vine and others. It is also useful to eat more currants, rowan berries, lemons, and persimmons.

Onions and garlic are the best choice for cleansing the body of various parasites; they should definitely be included in your diet if there are no contraindications.

To improve the body's microflora, it is useful to drink more dairy and fermented milk products, including store-bought formulations enriched with lactobacilli.

As for men who have developed bacterial balanoposthitis against the background of gardnerellosis, they can also be advised to strengthen their immunity and consume more pungent herbal antibiotics (onions and garlic). The urethra can be treated with the same compositions that women use for douching. Chamomile infusion is usually used to reduce inflammatory symptoms.

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Homeopathy

Bacterial vaginosis, characterized by the appearance of key cells in a smear that indicate a violation of the vaginal microflora, is considered an unusual disease in homeopathy. Alternative medicine has a slightly different approach to diagnosing and treating women's diseases, because here the focus is not so much on the nature of the detected infection, but on the cause that caused the disease.

But that's not all. Any of the reasons causing vaginal microflora disturbance will not lead to illness if a woman has strong immunity. And here begins the search for the cause, but not vaginal dysbacteriosis, but decreased immunity. If stress is the cause of this situation, the treatment will be one, if ecology is to blame - another, and if immunity has decreased due to chronic diseases, a third treatment regimen will be prescribed.

Moreover, an experienced homeopathic doctor relies not only on the diagnosis and the root cause of the disease, but also on the characteristics of the patient’s body: constitution, temperament, predisposition to various diseases, age, etc.

Based on the above, we can conclude that it makes sense to talk about specific drugs only after the patient has been seen by a homeopath. The treatment regimen in each specific case may differ greatly. And this is not surprising, because in homeopathy there are no separate drugs for dysbacteriosis, tonsillitis, rheumatism, hypertension, etc. Homeopathic drugs are multifunctional and help with various diseases, the main thing is to choose them correctly, and only a qualified homeopathic doctor can do this.