The results do not provide sufficient evidence for or against recommending probiotics for the treatment of BV .
BACKGROUND The dominance of lactobacilli in healthy vaginal microbiota and its depletion in bacterial vaginosis ( BV ) has given rise to the concept of oral or vaginal instillation of probiotic Lactobacillus strains for the management of this condition .
OBJECTIVES To ascertain the efficacy of probiotics in the treatment of BV .
Nucleic acid-based diagnosis of bacterial vaginosis and improved management using probiotic lactobacilli.
Bacterial vaginosis ( BV ) is a common condition in women that represents an imbalance of the vaginal microflora , lactobacilli depletion , and excess growth of mainly anaerobic Gram-negative pathogens . Diagnosis is made using a series of tests or a Gram stain of a vaginal smear . Treatment with antibiotics is quite effective , but recurrences are common . A study of 55 vaginal sample s from 11 postmenopausal women showed the presence of BV by the Gram stain-based Nugent scoring system , and polymerase chain reaction-denaturing gradient gel electrophoresis showed that Bacteroides or Prevotella species were the most common isolates recovered ( 24 of 25 ) , with Escherichia coli , Staphylococcus aureus , and Streptococcus agalactiae also found in some sample s. In one case , only Gardnerella vaginalis was found . These findings illustrate that BV remains common even among otherwise healthy women , but it is not caused solely by either Gardnerella or Mobiluncus . Use of a FemExam system ( Cooper Surgical , Shelton , CT ) , based upon elevated pH and trimethylamine levels , to screen vaginal smears from 59 healthy women showed poor correlation with the Gram stain method . A r and omized , placebo-controlled trial of these subjects showed that the lactobacilli-dominant microbiota was restored in subjects with BV but not in controls , following 2 months of daily oral intake of Lactobacillus rhamnosus GR-1 and Lactobacillus fermentum RC-14 . These studies show that nucleic acid-based methods are effective at identifying bacteria responsible for BV . If such methods could be used to develop a commercially available , self-use kit , women would be much better placed to take control of their own health , for example , using medicinal food or dietary supplement products such as the clinical ly proven probiotic strains L. rhamnosus GR-1 and L. fermentum RC-14
The results do not provide sufficient evidence for or against recommending probiotics for the treatment of BV .
BACKGROUND The dominance of lactobacilli in healthy vaginal microbiota and its depletion in bacterial vaginosis ( BV ) has given rise to the concept of oral or vaginal instillation of probiotic Lactobacillus strains for the management of this condition .
OBJECTIVES To ascertain the efficacy of probiotics in the treatment of BV .