Уважаемый доктор Алексей Живов!
Рекомендации по дозе азитромицина были взяты на основании статьи и с учетом, что длительность инфицирования у пациентки была все же более 3 недель (хотя и согласен, что это не одно и тоже, что 3-недельное наличие симптоматики):
Drugs Exp Clin Res. 2001;27(4):135-9.
Azithromycin and doxycycline in the treatment of female patients with acute urethral syndrome caused by Ureaplasma urealyticum: significance of duration of clinical symptoms.
Skerk V, Schonwald S, Krhen I, Rusinovic M, Strapac Z, Vukovic J.
One hundred ninety-two female patients with acute urethral syndrome caused by Ureaplasma urealyticum were examined. First, patients were divided into two groups: those with clinical symptoms present for less than 3 weeks before the start of treatment and those with clinical symptoms 3 weeks or longer before the beginning of therapy. The patients were then further divided into groups and randomized to receive azithromycin once daily in a single dose of 1 g or 500 mg once daily for 6 days, or to receive doxycycline 100 mg b.i.d. for 14 days or 100 mg b.i.d. for 7 days (eight study groups in all). Clinical and bacteriological efficacy were evaluated 3 weeks after the end of therapy. In the group of patients with disease symptoms lasting for 3 weeks or longer, eradication and clinical cure rates were significantly higher after the administration of azithromycin at a dose of 1 x 500 mg/6 days than after a single dose of 1 g (p < 0.001).
О иогуртах и не только при половых инфекциях:
Obstet Gynecol Surv. 2003 May;58(5):351-8.
Common complementary and alternative therapies for yeast vaginitis and bacterial vaginosis: a systematic review.
Van Kessel K, Assefi N, Marrazzo J, Eckert L.
Department of Obstetrics & Gynecology, University of Washington, Harborview Medical Center, Seattle, Washington 98104, USA.
kvk@u.washington.edu
...Lactobacillus recolonization (via yogurt or capsules) shows promise for the treatment of both yeast vaginitis and bacterial vaginosis with little potential for harm...
Тк не являюсь дистрибьютором или промотором к-либо молокозавода в России, а также не знаком с Российской молочной индустрией, поэтому просто рекомендую иогурты с живыми лакто или же бифидо-бактериями или же капсульные препараты с живыми культурами. (рекомендательный характер, не требует обязательного исполнения).
Что такое антибиотик-ассоциированная диарея (почему-то доктора у нас ее называют дисбактериозом) и как ее можно лечить/предупреждать здесь или др. аналогичные обучающие обзоры (tutorials)
Int J Antimicrob Agents. 2000 Dec;16(4):521-6.
Treatment and prevention of antibiotic associated diarrhea.
Bergogne-Berezin E.
Microbiology Department, University Paris 7, 100 bis rue du Cherche-Midi, 75006 Paris, France.
berezbiol@aol.com
Mild or severe episodes of antibiotic-associated diarrhea (AAD) are common side effects of antibiotic therapy. The incidence of AAD differs with the antibiotic and varies from 5 to 25%. The major form of intestinal disorders is the pseudomembranous colitis associated with Clostridium difficile which occurs in 10-20% of all AAD. In most cases of AAD discontinuation or replacement of the inciting antibiotic by another drug with lower AAD risk can be effective. For more severe cases involving C. difficile, the treatment of diarrhea requires an antibiotic treatment, with glycopeptides (vancomycin) or metronidazole. Another approach to AAD treatment or prevention is based on the use of non-pathogenic living organisms, capable of re-establishing the equilibrium of the intestinal ecosystem. Several organisms have been used in treatment or prophylaxis of AAD such as selected strains of Lactobacillus acidophilus, L. bulgaricus, Bifidobacterium longum, and Enterococcus faecium. Another biotherapeutic agent, a non-pathogenic yeast, Saccharomyces boulardii has been used. In animal models of C. difficile colitis initiated by clindamycin, animals treated with S. boulardii (at end of vancomycin therapy) had a significant decrease in C. difficile colony-forming units, and of toxin B production. In several clinical randomised trials (versus placebo), S. boulardii has demonstrated its effectiveness by decreasing significantly the occurrence of C. difficile colitis and preventing the pathogenic effects of toxins A and B of C. difficile. It has been shown to be a safe and effective therapy in relapses of C. difficile colitis. A good response has been seen in children with AAD, treated by S. boulardii only. In ICUs prevention of AAD remains based on limitation of antibiotic overuse and spread of C. difficile or other agents of AAD should be prevented by improved hygiene measures (single rooms, private bathrooms for patients, use of gloves and hand washing for personnel). In addition the increasing use of biotherapeutic agents such as S. boulardii should permit the prevention of the major side effect of antibiotics, i.e. AAD in at risk patients.
Clin Infect Dis. 1998 Oct;27(4):702-10.
Mechanisms and management of antibiotic-associated diarrhea.
Hogenauer C, Hammer HF, Krejs GJ, Reisinger EC.
Am J Gastroenterol. 2000 Jan;95(1 Suppl):S11-3.
The effect of probiotics on Clostridium difficile diarrhea.
Pochapin M.