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Probiotic for recurrent bacterial vaginosis.

One hundred twenty Chinese women (mean age, 37 years) with a history of at least two episodes of bacterial vaginosis (BV) in the previous year, but who were currently free of BV, were randomly assigned to receive, in double-blind fashion, daily prophylaxis with a vaginal capsule that contained 8 billion colony-forming units of Lactobacillus rhamnosus, L. acidophilus, and Streptococcus thermophilus (Probaclac Vaginal; Nicar Laboratories Inc., Blainville, Quebec, Canada) or placebo (lactose) for 7 days on, 7 days off, and 7 days on. The women were then examined 30 and 60 days after treatment. Compared with placebo, active treatment resulted in a lower recurrence rate of BV (15.8% vs. 45.0%; p < 0.001) and a lower incidence of Gardnerella vaginalis infection (3.5% vs. 18.3%; p = 0.02). At telephone follow-up 11 months after treatment, the incidence of BV symptoms was significantly lower in the active-treatment group than in the placebo group (10% vs. 28%; p < 0.05).


Comment: BV is the most common cause of vaginitis. It is typically caused by infection with G. vaginalis. Conventional therapy consists primarily of antibiotics. Probiotic organisms may help prevent BV and other vaginal infections by competitively excluding pathogens and by producing compounds (such as hydrogen peroxide) that inhibit the growth of pathogens. The results of the present study indicate that short-term vaginal application of a probiotic preparation was well tolerated and reduced the recurrence rate of BV and G. vaginalis infection. In previous research, an orally administered probiotic preparation (Fem-Dophilus; Jarrow Formulations), given twice a day for 30 days after a course of metronidazole, increased the cure rate in women with BV (Anukam K et al. Augmentation of antimicrobial metronidazole therapy of bacterial vaginosis with oral probiotic Lactobacillus rhamnosus GR-1 and Lactobacillus reuteri RC-14: randomized, double-blind, placebo controlled trial. Microbes Infect. 2006;8:1450-1454.)

Ya W et al. Efficacy of vaginal probiotic capsules for recurrent bacterial vaginosis: a double-blind, randomized, placebo-controlled study. Am J Obstet Gynecol. 2010;203:120.e1-e6.

by Alan R. Gaby, MD

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Title Annotation:Literature Review & Commentary
Author:Gaby, Alan R.
Publication:Townsend Letter
Geographic Code:9CHIN
Date:Feb 1, 2011
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