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Vaginal infections are highly spread among the female population and they impact the woman’s organism, fetal development and child health. They remain an important medical and social problem, so the optimizing the treatment is very important. The article is a review of the modern domestic and foreign publications about the etiological factors, pathogenesis, and local pharmacotherapy of nonspecific and candidiasis vaginitis and bacterial vaginosis, including their manifestation during pregnancy. The issues of vaginal infections in non-pregnant and pregnant women, the main risk factors for their development, the range of pathogens of infectious lesions of the vagina, which are the most common - bacterial vaginosis (G. vaginalis and A. vaginae), nonspecific vaginitis (Streptococcus spp., S. aureus, coagulase-negative staphylococci, E. coli, etc.), candidiasis vaginitis (C. albicans and C. non-albicans), and the importance of changes in the composition of the vaginal microbiome in the development of these diseases are demonstrated. Based on the data from scientific publications, the article presents the analysis of the sensitivity of pathogenic flora to anti-infective methods. The attention is drawn to the risks of nonspecific and candidiasis vaginitis and bacterial vaginosis during pregnancy (miscarriage and premature birth, placental insufficiency, etc.), the advantages and disadvantages of systemic and local therapy for these diseases, the comparative characteristics of individual drugs for topical therapy are given, taking into account the composition and pharmacodynamics of their components. The clinical and pharmaceutical benefits of a complex preparation that includes ternidazole, neomycin sulfate, nystatin and prednisolone sodium metasulfobenzoate and has the bactericidal (including antianaerobic), fungicidal, antiprotozoal, and anti-inflammatory effects have been analyzed. Data on the microbiological and clinical efficacy of the drug, its storage effect on the vaginal microbiome, and features of innovative technology for the manufacture of its dosage form are presented.

One of the key and strategically important problems of modern gynecology both around the world and in Ukraine is infectious and inflammatory diseases (IVD) of the lower genital tract: according to various estimates, back in the 90s of the last century, this diagnosis was made in about 40 % of patients in gynecological hospitals. Over the first decade of the 21st century, the incidence rate of genital IVI increased 1.4 times in 18–24-year-old patients, and 1.8 times in 25–29-year-old patients. At the same time, the costs of diagnostics and treatment have increased, which reach 50-60% of all costs for the provision of gynecological care to the population. In the structure of gynecological morbidity, the indicator of the number of patients with infectious and inflammatory diseases of the genital area continues to occupy a leading position in terms of frequency in the population, amounting to 60.4-65.0%, however, information from different authors regarding their true prevalence is very contradictory. So, according to the materials of the 33rd European Congress of the International Union against for Sexually Transmitted Infections (IUSTI-Europe), bacterial vaginosis (BV) occurs in 12-80% of women, vulvovaginal candidiasis – VVC (at least one episode in life) - in 75%, aerobic vaginitis (AV) – in 15-25% [8]. According to other authors, the prevalence of BV is 24-30%, VVC – 9.7-11.7%, nonspecific (aerobic) vaginitis – 5.0-23.7%. Combined drugs Neo-Penotran® Forte and Gainomax have a high safety profile, which is due to the unique features of the pharmacokinetics and pharmacodynamics of their components. This determines the advantages in the speed of bactericidal action over other antibacterial and antimycotic agents. These drugs are highly effective in the local treatment of BV and vulvovaginal infections, reaching 98.5% in some nosologies. The effectiveness and safety of the use of Neo-Penotran® Forte and Gainomax in the treatment of infections of the female genital area served as the basis for their inclusion in standard treatment regimens according to indications, and their use is regulated by the normative documents of the Ministry of Health of Ukraine.