Effectiveness of Lactobacillus-containing vaginal tablets in the treatment of symptomatic bacterial vaginosis

Abstract

The purpose of this study was to determine the effectiveness of Lactobacillus-containing vaginal tablets in the treatment of bacterial vaginosis (BV) and in the restoration of a healthy vaginal flora. Thirty-nine women with BV were enrolled in a double-blind, placebo-controlled clinical trial. Patients received either one Lactobacillus-containing tablet or placebo daily for 7 days. Clinical criteria, vaginal Gram stain scores and symptoms were compared with those at the initial visit and those at completion of therapy and 2 weeks later. After completion of therapy, all of the patients in the Lactobacillus-treated group (n = 18) were free of BV, showing a normal (83%) or intermediate (17%) vaginal flora, as compared with only two patients free of BV with intermediate flora (12%) from among the 16 placebo-treated women (p <0.001). Two weeks after completion of therapy, treatment was successful (score <7) in 61% of Lactobacillus-treated patients as compared with 19% of those in the placebo group (p <0.05). In the treatment group, the total number of symptomatic patients and the intensity of their symptoms, in particular vaginal malodour, were significantly reduced at both follow-up visits. The data indicate that intravaginal administration of exogenous selected strains of lactobacilli can restore a normal vaginal microbiota and be used in treating bacterial vaginosis.

Dairy Probiotic Foods and Bacterial Vaginosis: A Review on Mechanism of Action

“…Clinical trials in which patients were administered oral capsules, reported a positive effect of the treatment on BV [39, 41-43, 49, 56]. Vaginal probiotic tablets were reported to be effective in alleviating BV symptoms and decreasing its recurrence [1,4,52,53]. Vaginal capsules have also been reported to efficiently ease BV symptoms in some studies [3,42,50,55].…”

“…Probiotics are believed to protect the host against infections by means of several mechanisms including: [1] occupation of specific adhesion sites at the epithelial surface of the urinary tract; [2] maintenance of a low pH and production of antimicrobial substances like acids, hydrogen peroxide, and bacteriocins; [3] degradation of polyamines; and [4] the production of surfactants with antiadhesive properties [21,42].…”

“…Factors that upset this balance in the vagina are not well-understood. However, the activities or behaviours that have been related with BV incidence include having a new sex partner or multiple sex partners and douching [4,5]. BV is mainly followed by irritating symptoms mainly foul, fish-like or musty odor which is sometimes stronger after a woman has sex, watery or foamy, white (milky) or gray vaginal secretions, itching on the outside of the vagina and Burning or discomfort during urination [6].…”

“…Oral administration introduces the beneficial bacteria directly into the vagina; probiotics consumed orally are believed to ascend to the vaginal tract after they are excreted from the rectum. Mechanism through which probiotics play a role in BV treatment include: [1] occupation of specific adhesion sites at the epithelial surface of the urinary tract; [2] maintenance of a low pH and production of antimicrobial substances like acids, hydrogen peroxide and bacteriocins; [3] degradation of polyamines; and [4] the production of surfactants with antiadhesive properties [21]. Probiotics have been shown to exert the beneficial effects both in foods such as yoghurt [22], ice cream [23,24], and supplements [25].…”

Current views on vaginal microbiota and its impact on pregnancy outcomes

“…Так, D. Parent et al (1996) в 88 % случаев наблюдали нормализацию микрофлоры влага-лища в группе женщин, лечение БВ у которых проводилось путем интравагинального введе-ния капсул, содержащих L. acidophilus, в тече-ние 4 недель [65]. Позднее было проведено два клинических исследования с использованием пробиотиков, содержащих L. rhamnosus GR-1 и L. reuteri RC-14, в сравнении с применением метронидазола [66] [67], -с группой плацебо. Показано дву-кратное снижение заболеваемости БВ в группе с интравагинальным применением пробиоти-ков в сравнении с группой, в которой исполь-зовался метронидазол (65 и 33 % случаев соот-ветственно) [66], и выявлена эффективность лечения в 50 % случаев в группе с применением пробиотиков, содержащих L. brevis, L. salivarius и L. plantarum, в сравнении с группой плацебо (6 %) [67].…”