Analysis of antibiotic resistance of uropathogens in the aspect of empirical therapy
- Authors: Morozov A.M.1, Polyakov P.S.1, Nazarova A.A.1, Fisyuk E.A.1
-
Affiliations:
- Tver State Medical University, Ministry of Health of Russia
- Issue: Vol 36, No 11 (2025)
- Pages: 72-78
- Section: From Practice
- URL: https://ogarev-online.ru/0236-3054/article/view/362946
- DOI: https://doi.org/10.29296/25877305-2025-11-12
- ID: 362946
Cite item
Abstract
Urinary tract infections are one of the most common categories of bacterial infections in urological practice, with an annual incidence of approximately 150 million cases worldwide. The aim of this study is to optimize the choice of empirical initial therapy in urological practice. Analyzed the results of bacteriological examination of urine samples from patients treated in the urology department in 2018, 2019, and 2020. An assessment of the local susceptibility of uropathogens to antibacterial drugs revealed that the greatest number of microorganisms, according to an individual analysis of digital data, are sensitive to drugs such as gentamicin (an aminoglycoside), clindamycin (a lincosamide), and a penicillin. The conducted antibiotic susceptibility assessment revealed certain trends that must be considered when developing treatment strategies, as well as taking into account regional patterns of antibiotic resistance. The data obtained demonstrate the need for continuous updating of information on microbial susceptibility, as only up-to-date information will minimize errors in the selection of initial therapy.
About the authors
A. M. Morozov
Tver State Medical University, Ministry of Health of Russia
Author for correspondence.
Email: ammorozovv@gmail.com
ORCID iD: 0000-0003-4213-5379
SPIN-code: 6815-9332
Associate Professor, Candidate of Medical Sciences
Russian Federation, TverP. S. Polyakov
Tver State Medical University, Ministry of Health of Russia
Email: ammorozovv@gmail.com
ORCID iD: 0009-0001-0354-6872
Russian Federation, Tver
A. A. Nazarova
Tver State Medical University, Ministry of Health of Russia
Email: ammorozovv@gmail.com
ORCID iD: 0009-0001-6717-8685
SPIN-code: 5328-8209
Russian Federation, Tver
E. A. Fisyuk
Tver State Medical University, Ministry of Health of Russia
Email: ammorozovv@gmail.com
ORCID iD: 0009-0000-0582-7398
SPIN-code: 2392-8968
Russian Federation, Tver
References
- Малаева Е.Г. Инфекции мочевыводящих путей и микробиота. Проблемы здоровья и экологии. 2021; 18(3): 5–14 [Malaeva E.G. Urinary tract infections and microbiota. Health and Ecology Issues. 2021; 18 (3): 5–14 (in Russ.)]. doi: 10.51523/2708-6011.2021-18-3-1
- Nelson Z., Aslan A.T., Beahm N.P. et al. Guidelines for the Prevention, Diagnosis, and Management of Urinary Tract Infections in Pediatrics and Adults: A WikiGuidelines Group Consensus Statement. JAMA Network Open. 2024; 7 (12): e2453497. doi: 10.1001/jamanetworkopen.2024.53497
- Морозов А.М., Сергеев А.Н., Жуков С.В. и др. Проблемы выбора стартовой этиотропной терапии в хирургической практике. Вестник современной клинической медицины. 2022; 15(3): 45–53 [Morozov A.M., Sergeev A.N., Zhukov S.V. et al. The problem of choosing starting ethiotropic therapy in surgical practice. The Bulletin of Contemporary Clinical Medicine. 2022; 15 (3): 45–53 (in Russ.)]. doi: 10.20969/VSKM.2022.15(3).45-53
- Finucane T.E. Urinary tract infection and the microbiome. Am J Med. 2017; 130 (3): e97–e98. doi: 10.1016/j.amjmed.2016.08.018
- Майстренко М.А., Якушева Е.Н., Титов Д.С. Анализ проблемы антибиотикорезистентности. Антибиотики и Химиотерапия. 2023; 68 (5-6): 39–48 [Maistrenko M.A., Yakusheva E.N., Titov D.S. Analysis of The Antibiotic Resistance Problem. Antibiotics and Chemotherapy. 2023; 68 (5-6): 39–48 (in Russ.)]. doi: 10.37489/0235-2990-2023-68-5-6-39-48
- Землянко О.М., Рогоза Т.М., Журавлева Г.А. Механизмы множественной устойчивости бактерий к антибиотикам. Экологическая генетика. 2018; 16 (3): 4–17 [Zemlyanko O.M., Rogoza T.M., Zhouravleva G.A. Mechanisms of bacterial multiresistance to antibiotics. Ecological genetics. 2018; 16 (3): 4–17 (in Russ.)]. doi: 10.17816/ecogen1634-17
- Magistro G., Stief C. The urinary tract microbiome: the answer to all our open questions. Eur Urol Focus. 2019; 5 (1): 36–8. doi: 10.1016/j.euf.2018.06.011
- Ainsworth C. Microbiome: a bag of surprises. Nature. 2017; 551 (7679): S40–S41. doi: 10.1038/551S40a
- Морозов А.М., Шахматов К.Л., Алтунин А. А. и др. Нетравматический разрыв мочевого пузыря (клинический случай). Уральский медицинский журнал. 2025; 24 (3): 117–26 [Morozov A.M., Shakhmatov K.L., Altunin A.A. et al. Non-Traumatic Bladder Rupture (Clinical Case). Ural Medical Journal. 2025; 24 (3): 117–26 (in Russ.)]. doi: 10.52420/umj.24.3.117
- Antunes-Lopes T., Vale L., Coelho A.M. et al. The role of urinary microbiota in lower urinary tract dysfunction: a systematic review. Eur Urol Focus. 2020; 6 (2): 361–9. doi: 10.1016/j.euf.2018.09.011
- Jones J., Murphy C.P., Sleator R.D. et al. The urobiome, urinary tract infections, and the need for alternative therapeutics. Microb Pathog. 2021; 161(Pt B): 105295. doi: 10.1016/j.micpath.2021.105295
- Ammitzbøll N., Bau B.P.J., Bundgaard-Nielsen C. et al. Pre- and postmenopausal women have different core urinary microbiota. Sci Rep. 2021; 11 (1): 2212. doi: 10.1038/s41598-021-81790-8
- Zandbergen L.E., Halverson T., Brons J.K. et al. The good and the bad: Ecological interaction measurements between the urinary microbiota and uropathogens. Front Microbiol. 2021; 12: 659450. doi: 10.3389/fmicb.2021.659450
- Guglietta A. Recurrent urinary tract infections in women: Risk factors, etiology, pathogenesis and prophylaxis. Future Microbiol. 2017; 12 (3): 239–46. doi: 10.2217/fmb-2016-0145
- Yang B., Fang D., Lv Q. et al. Targeted Therapeutic Strategies in the Battle Against Pathogenic Bacteria. Front Pharmacol. 2021; 12: 673239. doi: 10.3389/fphar.2021.673239
- LaRocco M.T., Franek J., Leibach E.K. et al. Effectiveness of Preanalytic Practices on Contamination and Diagnostic Accuracy of Urine Cultures: a Laboratory Medicine Best Practices Systematic Review and Meta-analysis. Clin Microbiol Rev. 2016; 29 (1): 105–47. doi: 10.1128/CMR.00030-15
- Слукин П.В., Асташкин Е.И., Асланян Е.М. и др. Характеристика вирулентных штаммов Escherichia coli, выделенных от пациентов с урологической инфекцией. Журнал микробиологии, эпидемиологии и иммунобиологии. 2021; 98 (6): 671–84 [Slukin P.V., Astashkin E.I., Aslanyan E.M. et al. Characterization of virulent Escherichia coli strains isolated from patients with urological infection. Journal of microbiology, epidemiology and immunobiology. 2021; 98 (6): 671–84 (in Russ.)]. doi: 10.36233/0372-9311-134
- Козлова Н.С., Баранцевич Н.Е., Баранцевич Е.П. Чувствительность к антибиотикам эшерихий, выделенных в многопрофильном стационаре. Журнал акушерства и женских болезней. 2016; 65 (4): 83–9 [Kozlova N.S., Barantsevich N.E., Barantsevich E.P. Susceptibility to antibiotics in escherichiae isolated in a multidisciplinary medical centre. Journal of obstetrics and women's diseases. 2016; 65 (4): 83–9 (in Russ.)]. doi: 10.17816/JOWD65483-89.
- Отамуратова Н.Х., Абдухалилова Г.К., Ахмедова М.Д. Мониторинг устойчивости к антимикробным препаратам уропатогенных штаммов Escherichia coli. Инфекционные болезни: Новости. Мнения. Обучение. 2023; 12 (4): 59–64 [Otamuratova N.Kh., Abdukhal.il.ova G.K., Akhmedova M.D. Monitoring of antimicrobial resistance of uropathogenic strains of Escherichia coli. Infectious Diseases: News, Opinions, Training. 2023; 12 (4): 59–64 (in Russ.)]. doi: 10.33029/2305-3496-2023-12-4-59-64.
- Cubero M., Grau I., Tubau F. et al. Molecular epidemiology of klebsiella pneumoniae strains causing bloodstream infections in adults. Microb Drug Resist. 2018; 24 (7): 949–57. doi: 10.1089/mdr.2017.0107
- Hyun M., Noh C.I., Ryu S.Y. et al. Changing trends in clinical characteristics and antibiotic susceptibility of klebsiella pneumoniae bacteremia. Korean J Intern Med. 2018; 33 (3): 595–603. doi: 10.3904/kjim.2015.257
- Ивушкина Л.В., Миронов А.Ю. Микробиологический мониторинг Klebsiella Pneumonia и механизмы их резистентности к антимикробным препаратам у больных туберкулезом г. Москвы. Клиническая лабораторная диагностика. 2024; 69 (4): 131–41 [Ivushkina L.V., Mironov A.Yu. Microbiological monitoring of Klebsiella pneumoniae and mechanisms of their resistance to antimicrobial drugs in tuberculosis patients in Moscow. Russian Clinical Laboratory Diagnostics. 2024; 69 (4): 131–41 (in Russ.)]. DOI: 1051620/0869-2084-2024-69-4-131-141
- Huy T.X.N. Overcoming Klebsiella pneumoniae antibiotic resistance: new insights into mechanisms and drug discovery. Beni-Suef University Journal of Basic and Applied Sciences. 2024; 13: 13. doi: 10.1186/s43088-024-00470-4
- Büttner H., Mack D., Rohde H. Structural basis of Staphylococcus epidermidis biofilm formation: mechanisms and molecular interactions. Front Cell Infect Microbiol. 2015; 5: 14. doi: 10.3389/fcimb.2015.00014
- Lee D.H., Lee K., Kim Y.S. et al. Comprehensive genomic landscape of antibiotic resistance in Staphylococcus epidermidis. mSystems. 2024; 9(6): e0022624. doi: 10.1128/msystems.00226-24
- Pouget C., Chatre C., Lavigne J.P. et al. Effect of Antibiotic Exposure on Staphylococcus epidermidis Responsible for Catheter-Related Bacteremia. Int J Mol Sci. 2023; 24 (2): 1547. doi: 10.3390/ijms24021547
- Xu Z., Cave R., Chen L. et al. Antibiotic resistance and molecular characteristics of methicillin-resistant Staphylococcus epidermidis recovered from hospital personnel in China. J Glob Antimicrob Resist. 2020; 22: 195–201. doi: 10.1016/j.jgar.2020.02.013
- Nisar M., Rahman H., Ahmad S. et al. Staphylococcus epidermidis: Antimicrobial Resistance Profiles of Biofilm-Forming Isolates From Pediatric Bacteremia in Pakistan. J Trop Med. 2025; 2025: 8755082. doi: 10.1155/jotm/8755082
- Морозов А.М. Сергеев А.Н., Кадыков В.А. и др. О развитии антибиотикорезистентности в аспекте поликлинической службы. Вестник современной клинической медицины. 2021; 14 (5): 43–50 [Morozov A.M., Sergeev A.N., Kadykov V.A. et al. Development of antibiotic resistance in the aspect of outpatient services. Bulletin of Contemporary Clinical Medicine. 2021; 14 (5): 43–50 (in Russ.)]. doi: 10.20969/VSKM.2021.14(5).43-50
- McCarthy M., Raval A.P. The peri-menopause in a woman’s life: a systemic inflammatory phase that enables later neurodegenerative disease. J Neuroinflammation. 2020; 17 (1): 317. doi: 10.1186/s12974-020-01998-9
- Хабибулина М.М., Шамилов М.Д. Влияние препарата Фемо-Клим на качество жизни молодых женщин с измененным гормональным фоном. Врач. 2022; 33 (3): 12–6 [Khabibulina M.M., Shamilov M.D. The effect of the drug Femo-Klim on the quality of life of young women with altered hormonal background. Vrach. 2022; 33 (3): 12–6 (in Russ.)]. doi: 10.29296/25877305-2022-03-02
- Бурмистрова Л.А. Физико-химический анализ и биохимическая оценка биологической активности трутневого расплода. Дис. … канд. биол. наук. Рыбное, 1999 [Burmistrova L.A. Physico-chemical analysis and biochemical assessment of biological activity of drone brood. Dis. ... cand. biol. sciences. Rybnoe, 1999 (in Russ.)].
- Caron D.M. Insects & Human Nutrition. Am Bee J. 1978; 118 (6): 3889.
- Петрова Е.В, Калистратов В.Б. Полубояринов П.А. и др. Применяемый при климаксе препарат Фемо-Клим – лучшее негормональное решение гормональных проблем. Врач. 2019; 30 (1): 46–8 [Petrova E., Kalistratov V., Polyboyarinov P. et al. The menopause drug Femo-Klim is the best nonhormonal solution of hormonal problems. Vrach. 2019; 30 (1): 46–8 (in Russ.)]. doi: 10.29296/25877305-2019-01-08
- Тюзиков И.А., Калинченко С.Ю., Апетов С.С. Дефицит андрогенов у женщин в урогинекологической практике: патофизиология, клинические «маски» и фармакотерапия с применением трансдермальных форм тестостерона. Российский вестник акушера-гинеколога. 2014; 14 (1): 33–43 [Tiuzikov I.A., Kalinchenko S.Iu., Apetov S.S. Androgen deficiency in women in urogynecologic practice: Pathophysiology, clinical «masks» and pharmacotherapy using transdermal testosterone formulations. Russian Bulletin of Obstetrician-Gynecologist. 2014; 14 (1): 33–43 (in Russ.)].
- Witherby S. Efficacy and safety of topical testosterone for atrophic vaginitis in breast cancer patients on aromatase inhibitors: a pilot study. Breast Canser Res Treat. 2007; 106: abstract 6086.
- Melisko M., Rugo H., DeLuca A. A phase II study of vaginal testosterone cream vs Estring for vaginal dryness or decreased libido in woman with early stage breast cancer treated with aromatase inhibitors. Cancer Res. 2009; 69: 5038. doi: 10.1158/0008-5472.SABCS-09-5038
- Witherby S., Johnson J., Demers L. et al. Topical testosterone for breast cancer patients with vaginal atrophy related to aromatase inhibitors: a phase I/II study. The Oncologist. 2011; 16 (12): 424. doi: 10.1634/theoncologist.2010-0435
- Maia H., Casoy J., Valente J. Testosterone replacement therapy in climacteric: benefits beyond sexuality. Gynecol. Endocrin. 2009; 25 (1): 12–20. doi: 10.1080/09513590802360744
- Тюзиков И.А., Калиниченко С.Ю. Эндокринологические аспекты хронического цистита у женщин. Экспериментальная и клиническая урология. 2016; 3: 120–6 [Tyuzikov I.A., Kalinchenko S.Yu. Endocrinological aspects of chronic cystitis in women. Experimental and clinical urology. 2016; 3: 120–6 (in Russ.)].
- Mikulić M., Atanacković K.M., Kladar N. et al. Phytochemical Composition of Different Red Clover Genotypes Based on Plant Part and Genetic Traits. Foods. 2023; 13 (1): 103. doi: 10.3390/foods13010103
- Somjen D., Katzburg S., Vaya J. et al. Estrogenic activity of glabridin and glabrene from licorice roots on human osteoblasts and prepubertal rat skeletal tissues. J Steroid Biochem Mol Biol. 2004; 91 (4–5): 241–6. doi: 10.1016/j.jsbmb.2004.04.008
- Jafari F., Jafari M., Moghadam A.T. et al. A Review of Glycyrrhiza glabra (Licorice) Effects on Metabolic Syndrome. Adv Exp Med Biol. 2021; 1328: 385–400. doi: 10.1007/978-3-030-73234-9_25
- Соколов С.Я., Замотаев И.П. Справочник по лекарственным растениям (Фитотерапия). 2-е изд. М.: Медицина, 1988; 464 с. [Sokolov S.Ya., Zamotayev I.P. Reference book on medicinal plants (Phytotherapy). 2nd ed. Moscow: Medicine, 1988; 464 p. (in Russ.)].
- Фролов А.В. Фитотерапия предменструального синдрома. Новые Санкт-Петербургские врачебные ведомости. 2011; 2 [rolov A.V. Phytotherapy of premenstrual syndrome. New St. Petersburg Medical Vedomosti. 2011; 2 (in Russ.)].
- Суюнова М.Х. Все о галитозе: диагностика, лечение и профилактика (обзорная статья). Вестник Совета молодых ученых и специалистов Челябинской области. 2016; 4 (15): 68–77 [Suyunova M.K. All about halitosis: diagnosis, treatment and prevention (review). Bulletin of young scientists and professionals of Chelyabinsk Region. 2016;1;4(15):67-76 (in Russ.)].
- Барнаулов О.Д. Фитотерапия больных легочным туберкулезом. СПб: ЗАО «Весь», 1999; 416 с. [Barnaulov O.D. Phytotherapy of patients with pulmonary tuberculosis. SPb: ZAO “Vesya”, 1999; 416 p. (in Russ.)].
- Данилюк О.А. Фитотерапия в акушерстве: руководство для врачей. СПб: Изд-во Н-Л, 2014; 464 с. [Danilyuk O.A. Phytotherapy in obstetrics: a guide for doctors. SPb: Izd-vo N-L, 2014; 464 p. (in Russ.)].
- Rahte S., Evans R., Eugster P.J. et al. Salvia officinalis for hot flushes: towards determination of mechanism of activity and active principles. Planta Medica. 2013; 79 (9): 753–60. doi: 10.1055/s-0032-1328552
- Simakiani R., Forouhari S., Dehaghani A.S. et al. The effect of salvia officinalis tablet on hot flashes, night sweating, and estradiol hormone in postmenopausal women. Int J Med Res Health Sci. 2016; 5 (8): 257–63.
- Bommer S., Klein P., Suter A. First Time Proof of Sage’s Tolerability and Efficacy in Menopausal Women with Hot Flushes. Adv Ther. 2011; 28 (6): 490–500. doi: 10.1007/s12325-011-0027-z
- Dadfar F., Bamdad K. The effect of Saliva officinalis extract on the menopausal symptoms in postmenopausal women: An RCT. Int J Reprod Biomed. 2019; 17 (4): 287–92. doi: 10.18502/ijrm.v17i4.4555
- Oniga I., Parvu A.E., Toiu A. et al. Effects of Salvia officinalis L. extract on experimental acute inflammation. Rev Med Chir Soc Med Nat Iasi. 2007; 111 (1): 290–4.
- Rodrigues M.R., Kanazawa L.K., das Neves T.L. et al. Antinociceptive and anti-inflammatory potential of extract and isolated compounds from the leaves of Salvia officinalis in mice. J Ethnopharmacol. 2012; 139 (2); 519–26. doi: 10.1016/j.jep.2011.11.042
- Kolac U.K., Ustuner M.C., Tekin N. et al. The Anti-Inflammatory and Antioxidant Effects of Salvia officinalis on Lipopolysaccharide-Induced Inflammation in Rats. J Med Food. 2017; 20 (12): 1193–200. doi: 10.1089/jmf.2017.0035
- Bonesi M., Loizzo M.R., Acquaviva R., et al. Anti-inflammatory and Antioxidant Agents from Salvia Genus (Lamiaceae): An Assessment of the Current State of Knowledge. Antiinflamm Antiallergy Agents Med Chem. 2017; 16 (2): 70–86. doi: 10.2174/1871523016666170502121419
- Передерий Е.А., Юнусова И.А. Экспериментальное изучение противовоспалительных свойств модельных смесей густого экстракта шалфея лекарственного. Вестник Смоленской государственной медицинской академии. 2018; 17 (3): 26–30 [Perederii Ie.A., Yunusova I.A. Experimental study of the anti-inflammatory properties of model mixtures of thick salvia officinalis extract. Bulletin of Smolensk State Medical Academy. 2018; 17 (3): 26-30 (in Russ.)].
- Geuenich S., Goffinet C., Venzke S. et al. Aqueous extracts from peppermint, sage and lemon balm leaves display potent anti-HIV-1 activity by increasing the virion density. Retrovirology. 2008; 5 (1): 27. doi: 10.1186/1742-4690-5-27
- Шкиль Н.А., Чупахина Н.В., Казаринова Н.В. и др. Влияние эфирных масел на изменение чувствительности микроорганизмов к антибиотикам. Растительные ресурсы. 2006; 1: 100–6 [Shkil N.A., Chupakhina N.V., Kazarinova N.V. et al. Essential oils influence on change of microorganisms sensitivity to antibiotics. Rastitelnye Resursy. 2006; 1: 100–6 (in Russ.)].
- Касьянов Г.И., Сязин И.Е., Лугинин М.И. и др. Технология криообработки и криопереработки растительного сырья. Современные научные исследования и инновации. 2012; 3 (11): 6 [Kasyanov G.I.1, Syazin I.E.1, Luginin M.I. et al. Technology of cryoprocessing and cryoreprocessing of vegetative raw materials. Modern Scientific Research and Innovations. 2012; 3 (11): 6 (in Russ.)].
- Roueche J. et al. Clinical trial report of doublebind study of beta-alanin versus placebo in the treatment of hot flushes caused by climacteric of cutaneous vasodilatation during the postmenopausal hot flash. Menopause. 2011; 18 (4): 359–65.
- Лабыгина А.В., Лазарева Л.М., Сутурина Л.В. и др. Коррекция ранних проявлений климактерического синдрома у женщин с естественной и ятрогенной менопаузой. Научные труды SWorld. 2013; 38 (2): 9–18 [Labygina A.V., Lazareva L.M., Suturina L.V. et al. Correction of early manifestations of menopausal syndrome in women with natural and iatrogenic menopause. Scientific Proceedings of SWorld. 2013; 38 (2): 9–18 (in Russ.)].
- Зароченцева Н.В., Джиджихия Л.К. Возможности применения клималанина при вазомоторных пароксизмах у женщин в климактерическом периоде. Российский вестник акушера-гинеколога. 2012; 3: 92–7 [Zarochentseva NV, Dzhidzhikhiia LK. Possibilities of using klimalanin in menopausal women with vasomotor paroxysms. Russian Bulletin of Obstetrician-Gynecologist. 2012; 12 (3): 92–7 (in Russ.)].
- Casper R.F., Yen S.S. Neuroendocrinology of menopausal flushes: an hypothesis of flush mechanism. Clin Endocrinol (Oxford). 1985; 22 (3): 293–312. doi: 10.1111/j.1365-2265.1985.tb03243.x
- Yamadera W., Inagawa K., Chiba S. et al. Glycine ingestion improves subjective sleep quality in human volunteers, correlating with polysomnographic changes. Sleep and Biological Rhythms. 2007; 5(2): 126–31. doi: 10.1111/j.1479-8425.2007.00262.x
- Виноградова О.П., Бирючкова О.А., Михеева С.В. Оценка эффективности и безопасности комбинированного препарата «Фемо-Клим» у пациенток с перенесенным онкологическим заболеванием и умеренными менопаузальными расстройствами. Акушерство, гинекология и репродукция. 2024; 18 (1): 135–46 [Vinogradova О.Р., Biryuchkova О.А., Mikheeva S.V. Effectiveness and safety of the combination drug "Femo-Klim" evaluated in patients with former cancer and moderate menopausal disorders. Obstetrics, Gynecology and Reproduction. 2024; 18 (1): 135–46 (in Russ.)]. doi: 10.17749/2313-7347/ob.gyn.rep.2024.484
- Загубная О.А., Нарциссов Я.Р. Молекулярные механизмы, лежащие в основе терапевтического действия витамина В6. Фармация и фармакология. 2022; 10 (6): 500–14 [Zagubnaya O.A., Nartsissov Y.R. Molecular mechanisms underlying therapeutic action of vitamin B6. Pharmacy & Pharmacology. 2022; 10 (6): 500–14 (in Russ.)]. doi: 10.19163/2307-9266-2022-10-6-500-514
- Виноградова О.П., Сергеева-Кондраченко М.Ю., Бирючкова О.А. и др. Опыт применения негормонального препарата как альтернативы заместительной гормональной терапии в ведении пациенток с климактерическим синдромом средней степени тяжести. Акушерство и гинекология: Новости. Мнения. Обучения. 2023; 11 (1): 43–9 [Vinogradova O.P., Sergeeva-Kondrachenko M.Yu., Biryuchkova O.A. et al. Experience in the use of a non-hormonal drug as an alternative to hormone replacement therapy in the management of patients with moderate severity of menopausal syndrome. Obstetrics and Gynecology: News, Opinions, Training. 2023; 11 (1): 43–9 (in Russ.)]. doi: 10.33029/2303-9698-2023-11-1-43-49
- Виноградова О.П., Бирючкова О.А., Можжухина И.Н. Альтернативные подходы к ведению пациенток с менопаузальными расстройствами. Акушерство и гинекология: новости, мнения, обучение. 2021; 10 (1): 51–9 [Vinogradova O.P., Biryuchkova O.A., Mozhzhukhina I.N. Alternative approaches to clinical management of patients with menopausal disorders. Obstetrics and Gynecology: News, Opinions, Training. 2022; 10 (1): 51–9 DOI: (in Russ.)]. doi: 10.33029/2303-9698-2022-10-1-51-59
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