The use of Lactobacillus rhamnosus in the therapy of bacterial vaginosis. Evaluation of clinical efficacy in a population of 40 women treated for 24 months
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Bacterial vaginosis (BV) is the most prevalent vaginal disorder in adult women worldwide. A number of clinical studies indicate that re-establishment of the physiological ecosystem by re-colonization of vaginal mucosa by lactobacilli may be an effective therapy for BV both after initial antimicrobial therapy or when given alone. A vaginal pH <4.5 is considered physiological and its measurement has been reported as an objective parameter, very sensitive to alterations of vaginal microflora and correlated with clinically relevant BV.
The aims of this work were to assess the effectiveness of a long-term (24 months) intravaginal treatment with Lactobacillus rhamnosus (NORMOGIN®) on the vaginal pH and on the clinical symptoms in a group of 40 women affected by BV diagnosed by the Amsel criteria.
A prospective open clinical trial was performed in 40 consecutive cases evaluated for B.V. by the Amsel criteria.
Vaginal pH was above the physiological value of 4.5 in 36 out of 40 patients at the first visit. It returned under 4.5 value in 24/40 and 32/40 women after 12 and 24 months of treatment, respectively. pH values were significantly decreased at 12 month treatment (P < 0.001) and further reduction in pH values was found at 24 months of treatment (P < 0.02 vs. 12 months). The gradual return to a vaginal physiological pH was associated with a reduction of the intensity of symptoms as shown by the decrease in the symptoms score.
The present study supports the use of pH measurement for sensitive, objective, and simple therapy follow-up in women with BV and shows that long-term administration of vaginal tablets containing Lactobacillus rhamnosus represents an effective and safe treatment for restoring the physiological vaginal pH and controlling BV symptoms.
KeywordsVaginal microflora Vaginal pH Lactobacillus rhamnosus vaginal tablets
Conflict of interest statement
- 4.Eschenbach DA (1993) History and review of bacterial vaginosis. Am J Obstet Gynecol 169(2 Pt 2): 441–445Google Scholar
- 13.ACOG technical bulletin (1996) Vaginitis. Number 226–July 1996 (replaces No. 221, March 1996). Committee on technical bulletins of the American College of Obstetricians and Gynecologists. Int J Gynaecol Obstet 54(3):293–302Google Scholar
- 14.CDC—Centers for Disease Control and Prevention (2006) Pathogenesis of abnormal vaginal flora. Am J Obstet Gynecol 182:872–878Google Scholar
- 15.Parent D, Bossens M, Bayot D, Kirkpatrick C, Graf F, Wilkinson FE, Kaiser RR (1996) Therapy of bacterial vaginosis using exogenously-applied Lactobacilli acidophili and a low dose of estriol: a placebo-controlled multicentric clinical trial. Arzneim Forsch/Drug Res 46(1):68–73Google Scholar
- 18.Hay PE (1998) Recurrent bacterial vaginosis. Dermatol Clin 16:769–773, xii–xiiiGoogle Scholar
- 19.Carey JC, Klebanoff MA, Hauth JC, Hillier SL, Thom EA, Ernest JM, Heine RP et al (2000) Metronidazole to prevent preterm delivery in pregnant women with asymptomatic bacterial vaginosis National Institute of Child Health and Human Development Network of Maternal-Fetal Medicine Units. N Engl J Med 342:534–540CrossRefPubMedGoogle Scholar
- 21.Swidinski A, Mendling W, Loening-Baucke V, Swidinski S, Dorffel Y, Scolze J, Lochs H, Verstraelen H (2008) An adherent Gardnerella Vaginalis biofilm persists on the vaginal epithelium after standard therapy with oral metronidazole. Am J Obstet Gynecol 198:97–99Google Scholar
- 22.Rossi A, Cattadori F, Corti B (2003) L’ecosistema vaginale: come proteggerlo, come conservarlo. La Rivista italiana di Ostetricia e Ginecologia 17:21–23Google Scholar