The Effect of Supplementation of Standard Antibiotic Therapy with Oral Probiotics for Bacterial Vaginosis
Background: Bacterial vaginosis is a common cause of vaginal infection worldwide in women of child bearing age. It can be asymptomatic or mild infection but can lead to many complications especially during pregnancy. Recurrence is also frequently seen in women suffering from bacterial vaginosis. This infection usually occurs when normal lactobacillus flora in vagina is disrupted and replaced by pathogens. Administration of probiotics will restore normal vaginal flora and maintain normal pH and it could prove to be a reliable alternative to antibiotics in future.
Objective: To assess the effect of supplementation of standard antibiotic therapy with oral probiotics (Lactobacillus) for treatment of bacterial vaginosis.
Material Methods: It was an open labeled prospective study in which 100 women diagnosed with bacterial vaginosis were randomly divided into two groups. Diagnosis was made using Amselâ€™s criteria and Nugent scoring was done. Group A was given Oral Metronidazole, 400 mg BD for 7 days along with oral probiotic tablet containing Lactobacillus rhamnosus BD for 6 weeks whereas Group B was administered Oral Metronidazole, 400 mg BD for 7 days. Patients were assessed at 7 days for symptomatic improvement and again at the end of 6 weeks using Nugent scores. Results obtained were then compared.
Results: Out of all patients 2 patients in Group A and 5 patients in Group B could not complete the study. At the end of 7 days, there was improvement in symptoms ie decrease in itching, odour and discharge. There was a significant difference in mean Nugent score before and after treatment between group A and group B at the end of 6 weeks.
Conclusion: This study concluded that improvement in patients taking probiotics along with standard antibiotic therapy was significantly more as compared to antibiotics alone.
Martinez RCR, Franchesini SA, Patta MC, Quintana SM, Gomes BC, Martinis EC, et al. Improved cure of bacterial vaginosis with single dose of Tinidazole(2g), Lactobacillus rhamnosus GR-1 and Lactobacillus reuteri RC14:a randomized, double blind, placebo controlled trial. Can J Microbiol 2009;55:1338.
Marcone V, Calzolari E, Bertini M. Effectiveness of vaginal administration of Lactobacillus rhamnosus following conventional metronidazole therapy how to lower the rate of bacterial vaginosis recurrences. New Microbiol 2008;31(3):42933.
Oduyebo OO, Anorlu TI, Oqunsola FT. The effects of antimicrobial therapy on bacterial vaginosis in non pregnant women. Cochrane Database Syst Rev 2009;3:CD006055.
Hager WD, Rapp RP. Metronidazole. Obstetrics and Gynaecology clinics of North America 1992; 19:497-510.
Trexlar MF, Fraser TG, Jones MP. Fulminant pseudomembranous colitis caused by clindamycin phosphate vaginal cream. American journal of Gastroenterology 1997;92:2112-3.
Homayouni A, Bastani P, Ziyadi S, Mohammad AS, Ghalibaf M, Mortazavian AM, et al. Effects of probiotics on the recurrence of bacterial vaginosis: a review. J Low Genit Tract Dis 2014;18(1):79-86.
Klebanoff S, Hillier SL, Eschenbach DA, Waltersdorph AM. Control of the microbial flora of the vagina by H202 generating Lactobacilli. Journal of Infectitious diseases 1991;164:94-100.
Eschenbach DA, Davick PR, Williams BL. Prevalence of hydrogen peroxide producing Lactobacillus species in normal women and women with bacterial vaginosis. Journal of Clinical Microbiology 1989;27:251-6.
Laxmi U, Bhat G, Kotigadd S, Shenoy S. Comparison of the Methods of Diagnosis of Bacterial Vaginosis. J Clin Diag Res 2011;5:498-501.
Gomty Mahajan, Amita Mahajan, Shashi Chopra, Kailash Chand. Comparison of Different Diagnostic Methods of Bacterial Vaginosis â€“ Amselâ€™s vs Neugent. Int J Curr Microbiol App Sci 2017;6(5): 1442-8.
Livengood CH. Bacterial vaginosis: an overview. Rev Obstet & Gynecol 2009;2(1):2837.
Falagas M, Betsi GI, Athanasiou S. Probiotics for the treatment of women with bacterial vaginosis. Clin Microbiol Infect 2007;13(7):657-64.
Vujic G, Knez AJ, Stefanovic VD, Vrbanovic VK. Efficacy of orally applied probiotic capsules for bacterial vaginosis and other vaginal infections: a double blind, randomized, placebo controlled study. European Journal of Obstetrics & Gynaecology and Reproductive Biology 2013;168: 75-9.
Heczko PB, Tomusiak A, Adamski P, Jakimiuk AJ, Stefanski G, Cichonska AM, et al. Supplemetation of standard antibiotic therapy with oral probiotics for bacterial vaginosis and aerobic vaginitis: a randomised, double blind, placebo controlled trial. BMC Womenâ€™s Health 2015;15:115-26.
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