Dequalinium chloride in the treatment of vaginal infections

The most common inflammatory and infectious diseases of the lower genital tract include bacterial vaginosis (BV), vulvovaginal candidiasis (VVC), aerobic vaginitis, and mixed infections. Standard modern therapies show acceptable but short-term efficacy in most cases, and high recurrence rates and increased antimicrobial resistance remain an unresolved issue. Moreover, vaginal infections are associated with different adverse outcomes both in terms of higher incidence of infertility among couples and gestational complications, having a serious impact on patients’ quality of life. The determination of appropriate management tactics for these women, especially in mixed infections, is quite a challenge for clinicians. This metaanalysis evaluates the efficacy of topical therapy with antimicrobial antiseptics containing dequalinium chloride for various types of vaginal infections. Objective. To analyze the clinical and microbiological efficacy and safety of dequalinium chloride in the treatment of vaginal infections of different etiologies. Materials and methods. A review of selected scientific publications over the past 40 years on the use of dequalinium chloride in the treatment of vaginal infections with assessing the efficacy and safety of its topical use in women was conducted. A total of 4,783 patients (from 26 studies) were included. Results. Dequalinium chloride is an antimicrobial antiseptic agent with broad bactericidal and fungicidal activity and low systemic absorption after vaginal administration. At the same time, dequalinium chloride has similar clinical efficacy to clindamycin when used topically in the treatment of bacterial vaginosis, and its broad antimicrobial activity appears to be most suitable for the treatment of mixed vaginal infections. In addition, the development of microbial resistance to this drug is unlikely due to its pluripotent mechanism of action and local application. Conclusion. The analysis showed that the current formulation of dequalinium chloride (10 mg vaginal tablets) as 6-day therapy with its broad spectrum of antimicrobial activity and good tolerability offers a safe and effective option for empiric therapy of various vaginal infections in daily practice. Key words: vaginal infections, bacterial vaginosis, vulvovaginal candidiasis, anaerobic vaginitis, dequalinium chloride