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Vaginal colonisation by probiotic lactobacilli and clinical outcome in women conventionally treated for bacterial vaginosis and yeast infection.
BMC Infect Dis. 2015 Jul 03; 15:255.BI

Abstract

BACKGROUND

The aim of this study was to investigate the colonisation by lactobacilli and clinical outcome in women with bacterial vaginosis (BV) and recurrent vulvovaginal candidiasis (R-VVC) receiving antibiotic or anti-fungal treatment in combination with the probiotic EcoVag® capsules.

METHODS

A total of 40 Scandinavian women diagnosed with BV or VVC on the basis of Amsel's criteria or clinical symptoms were consecutively recruited in two pilot open label clinical trials. In trial I, women with BV were treated with clindamycin and metronidazole followed by vaginal EcoVag® capsules, containing Lactobacillus rhamnosus DSM 14870 and Lactobacillus gasseri DSM 14869, for 5 consecutive days after each antibiotic treatment. In trial II, women were recruited in three groups as follows: women with BV receiving clindamycin and metronidazole treatment together with a prolonged administration of EcoVag® (10 consecutive days after each antibiotic treatment followed by weekly administration of capsules for next four months), women with R-VVC receiving extended fluconazole and EcoVag® treatment, and women receiving extended fluconazole treatments only. The difference in frequency of isolation of EcoVag® strains or other lactobacilli between groups was compared by Fisher's exact test.

RESULTS

The 6-month cure rate for BV was 50 % in trial I while both the 6- and 12-month cure rates were 67 % in trial II. The 6- and 12-month cure rates for VVC were 100 % and 89 % in women receiving fluconazole and EcoVag®, and 100 % and 70 % in women receiving fluconazole only. The frequency of isolation of any Lactobacillus species during the course of the study was associated with cure of BV in trial I and II, whereas the frequency of isolation of EcoVag® strains was significantly associated with the cure of BV in trial II only. As previously observed, a change in sexual partner was associated with relapse of BV with an Odds ratio of 77 (95 % CI: 2.665 to 2225).

CONCLUSIONS

The study suggests that the treatment with antibiotics or anti-fungal medication in combination with EcoVag® capsules provide long-term cure against BV and R-VVC as compared to previous reports.

TRIAL REGISTRATION

ClinicalTrials.gov NCT02295579 . Registered November 20, 2014.

Authors+Show Affiliations

Division of Clinical Immunology, Department of Laboratory Medicine, Karolinska Institutet at Karolinska University Hospital Huddinge, Stockholm, Sweden. snlsll@gmail.com.Bifodan AS, Hundested, Denmark. erb@bifodan.com.Division of Clinical Immunology, Department of Laboratory Medicine, Karolinska Institutet at Karolinska University Hospital Huddinge, Stockholm, Sweden. Lennart.Hammarstrom@ki.se.Division of Clinical Immunology, Department of Laboratory Medicine, Karolinska Institutet at Karolinska University Hospital Huddinge, Stockholm, Sweden. Harold.Marcotte@ki.se.Department of Obstetrics and Gynaecology Kärnsjukhuset, Skaraborg hospital and University of Skövde, Skövde, Sweden. p-g.larsson@telia.com.

Pub Type(s)

Clinical Trial
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

26137971

Citation

Pendharkar, Sonal, et al. "Vaginal Colonisation By Probiotic Lactobacilli and Clinical Outcome in Women Conventionally Treated for Bacterial Vaginosis and Yeast Infection." BMC Infectious Diseases, vol. 15, 2015, p. 255.
Pendharkar S, Brandsborg E, Hammarström L, et al. Vaginal colonisation by probiotic lactobacilli and clinical outcome in women conventionally treated for bacterial vaginosis and yeast infection. BMC Infect Dis. 2015;15:255.
Pendharkar, S., Brandsborg, E., Hammarström, L., Marcotte, H., & Larsson, P. G. (2015). Vaginal colonisation by probiotic lactobacilli and clinical outcome in women conventionally treated for bacterial vaginosis and yeast infection. BMC Infectious Diseases, 15, 255. https://doi.org/10.1186/s12879-015-0971-3
Pendharkar S, et al. Vaginal Colonisation By Probiotic Lactobacilli and Clinical Outcome in Women Conventionally Treated for Bacterial Vaginosis and Yeast Infection. BMC Infect Dis. 2015 Jul 3;15:255. PubMed PMID: 26137971.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Vaginal colonisation by probiotic lactobacilli and clinical outcome in women conventionally treated for bacterial vaginosis and yeast infection. AU - Pendharkar,Sonal, AU - Brandsborg,Erik, AU - Hammarström,Lennart, AU - Marcotte,Harold, AU - Larsson,Per-Göran, Y1 - 2015/07/03/ PY - 2014/11/24/received PY - 2015/05/29/accepted PY - 2015/7/4/entrez PY - 2015/7/4/pubmed PY - 2016/1/8/medline SP - 255 EP - 255 JF - BMC infectious diseases JO - BMC Infect Dis VL - 15 N2 - BACKGROUND: The aim of this study was to investigate the colonisation by lactobacilli and clinical outcome in women with bacterial vaginosis (BV) and recurrent vulvovaginal candidiasis (R-VVC) receiving antibiotic or anti-fungal treatment in combination with the probiotic EcoVag® capsules. METHODS: A total of 40 Scandinavian women diagnosed with BV or VVC on the basis of Amsel's criteria or clinical symptoms were consecutively recruited in two pilot open label clinical trials. In trial I, women with BV were treated with clindamycin and metronidazole followed by vaginal EcoVag® capsules, containing Lactobacillus rhamnosus DSM 14870 and Lactobacillus gasseri DSM 14869, for 5 consecutive days after each antibiotic treatment. In trial II, women were recruited in three groups as follows: women with BV receiving clindamycin and metronidazole treatment together with a prolonged administration of EcoVag® (10 consecutive days after each antibiotic treatment followed by weekly administration of capsules for next four months), women with R-VVC receiving extended fluconazole and EcoVag® treatment, and women receiving extended fluconazole treatments only. The difference in frequency of isolation of EcoVag® strains or other lactobacilli between groups was compared by Fisher's exact test. RESULTS: The 6-month cure rate for BV was 50 % in trial I while both the 6- and 12-month cure rates were 67 % in trial II. The 6- and 12-month cure rates for VVC were 100 % and 89 % in women receiving fluconazole and EcoVag®, and 100 % and 70 % in women receiving fluconazole only. The frequency of isolation of any Lactobacillus species during the course of the study was associated with cure of BV in trial I and II, whereas the frequency of isolation of EcoVag® strains was significantly associated with the cure of BV in trial II only. As previously observed, a change in sexual partner was associated with relapse of BV with an Odds ratio of 77 (95 % CI: 2.665 to 2225). CONCLUSIONS: The study suggests that the treatment with antibiotics or anti-fungal medication in combination with EcoVag® capsules provide long-term cure against BV and R-VVC as compared to previous reports. TRIAL REGISTRATION: ClinicalTrials.gov NCT02295579 . Registered November 20, 2014. SN - 1471-2334 UR - https://www.unboundmedicine.com/medline/citation/26137971/Vaginal_colonisation_by_probiotic_lactobacilli_and_clinical_outcome_in_women_conventionally_treated_for_bacterial_vaginosis_and_yeast_infection_ L2 - https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-015-0971-3 DB - PRIME DP - Unbound Medicine ER -