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The restoration of the vaginal microbiota after treatment for bacterial vaginosis with metronidazole or probiotics.
Microb Ecol. 2013 Apr; 65(3):773-80.ME

Abstract

Whether or not treatment with antibiotics or probiotics for bacterial vaginosis (BV) is associated with a change in the diversity of vaginal microbiota in women was investigated. One hundred fifteen women, consisting of 30 healthy subjects, 30 BV-positive control subjects, 30 subjects with BV treated with a 7-day metronidazole regimen, and 25 subjects with BV treated with a 10-day probiotics regimen, were analyzed to determine the efficacy and disparity of diversity and richness of vaginal microbiota using 454 pyrosequencing. Follow-up visits at days 5 and 30 showed a greater BV cure rate in the probiotics-treated subjects (88.0 and 96 %, respectively) compared to the metronidazole-treated subjects (83.3 and 70 %, respectively [p = 0.625 at day 5 and p = 0.013 at day 30]). Treatment with metronidazole reduced the taxa diversity and eradicated most of the BV-associated phylotypes, while probiotics only suppressed the overgrowth and re-established vaginal homeostasis gradually and steadily. Despite significant interindividual variation, the microbiota of the actively treated groups or participants constituted a unique profile. Along with the decrease in pathogenic bacteria, such as Gardnerella, Atopobium, Prevotella, Megasphaera, Coriobacteriaceae, Lachnospiraceae, Mycoplasma, and Sneathia, a Lactobacillus-dominated vaginal microbiota was recovered. Acting as vaginal sentinels and biomarkers, the relative abundance of Lactobacillus and pathogenic bacteria determined the consistency of the BV clinical and microbiologic cure rates, as well as recurrent BV. Both 7-day intravaginal metronidazole and 10-day intravaginal probiotics have good efficacy against BV, while probiotics maintained normal vaginal microbiota longer due to effective and steady vaginal microbiota restoration, which provide new insights into BV treatment.

Authors+Show Affiliations

State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China. lingzongxin_lzx@163.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

23250116

Citation

Ling, Zongxin, et al. "The Restoration of the Vaginal Microbiota After Treatment for Bacterial Vaginosis With Metronidazole or Probiotics." Microbial Ecology, vol. 65, no. 3, 2013, pp. 773-80.
Ling Z, Liu X, Chen W, et al. The restoration of the vaginal microbiota after treatment for bacterial vaginosis with metronidazole or probiotics. Microb Ecol. 2013;65(3):773-80.
Ling, Z., Liu, X., Chen, W., Luo, Y., Yuan, L., Xia, Y., Nelson, K. E., Huang, S., Zhang, S., Wang, Y., Yuan, J., Li, L., & Xiang, C. (2013). The restoration of the vaginal microbiota after treatment for bacterial vaginosis with metronidazole or probiotics. Microbial Ecology, 65(3), 773-80. https://doi.org/10.1007/s00248-012-0154-3
Ling Z, et al. The Restoration of the Vaginal Microbiota After Treatment for Bacterial Vaginosis With Metronidazole or Probiotics. Microb Ecol. 2013;65(3):773-80. PubMed PMID: 23250116.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The restoration of the vaginal microbiota after treatment for bacterial vaginosis with metronidazole or probiotics. AU - Ling,Zongxin, AU - Liu,Xia, AU - Chen,Weiguang, AU - Luo,Yueqiu, AU - Yuan,Li, AU - Xia,Yaxian, AU - Nelson,Karen E, AU - Huang,Shaolei, AU - Zhang,Shaoen, AU - Wang,Yuezhu, AU - Yuan,Jieli, AU - Li,Lanjuan, AU - Xiang,Charlie, Y1 - 2012/12/19/ PY - 2012/09/11/received PY - 2012/12/06/accepted PY - 2012/12/20/entrez PY - 2012/12/20/pubmed PY - 2013/9/17/medline SP - 773 EP - 80 JF - Microbial ecology JO - Microb Ecol VL - 65 IS - 3 N2 - Whether or not treatment with antibiotics or probiotics for bacterial vaginosis (BV) is associated with a change in the diversity of vaginal microbiota in women was investigated. One hundred fifteen women, consisting of 30 healthy subjects, 30 BV-positive control subjects, 30 subjects with BV treated with a 7-day metronidazole regimen, and 25 subjects with BV treated with a 10-day probiotics regimen, were analyzed to determine the efficacy and disparity of diversity and richness of vaginal microbiota using 454 pyrosequencing. Follow-up visits at days 5 and 30 showed a greater BV cure rate in the probiotics-treated subjects (88.0 and 96 %, respectively) compared to the metronidazole-treated subjects (83.3 and 70 %, respectively [p = 0.625 at day 5 and p = 0.013 at day 30]). Treatment with metronidazole reduced the taxa diversity and eradicated most of the BV-associated phylotypes, while probiotics only suppressed the overgrowth and re-established vaginal homeostasis gradually and steadily. Despite significant interindividual variation, the microbiota of the actively treated groups or participants constituted a unique profile. Along with the decrease in pathogenic bacteria, such as Gardnerella, Atopobium, Prevotella, Megasphaera, Coriobacteriaceae, Lachnospiraceae, Mycoplasma, and Sneathia, a Lactobacillus-dominated vaginal microbiota was recovered. Acting as vaginal sentinels and biomarkers, the relative abundance of Lactobacillus and pathogenic bacteria determined the consistency of the BV clinical and microbiologic cure rates, as well as recurrent BV. Both 7-day intravaginal metronidazole and 10-day intravaginal probiotics have good efficacy against BV, while probiotics maintained normal vaginal microbiota longer due to effective and steady vaginal microbiota restoration, which provide new insights into BV treatment. SN - 1432-184X UR - https://www.unboundmedicine.com/medline/citation/23250116/The_restoration_of_the_vaginal_microbiota_after_treatment_for_bacterial_vaginosis_with_metronidazole_or_probiotics_ L2 - https://dx.doi.org/10.1007/s00248-012-0154-3 DB - PRIME DP - Unbound Medicine ER -