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 .
Diagnosis and clinical manifestations of bacterial vaginosis.
Among 640 r and omly selected women who were attending a sexually transmitted disease clinic and did not have trichomoniasis , 33 % had bacterial vaginosis as defined by a composite of four clinical criteria : ( 1 ) Vaginal discharge was homogeneous ; ( 2 ) vaginal discharge had a pH greater than or equal to 4.7 ; ( 3 ) vaginal discharge had an amine-like odor when mixed with 10 % potassium hydroxide ; ( 4 ) vaginal discharge contained clue cells representing greater than or equal to 20 % of vaginal epithelial cells . Previously published Gram stain criteria for bacterial vaginosis correlated better than results of semiquantitative cultures for Gardnerella vaginalis with presence or absence of clue cells and with composite clinical criteria . Of 293 women with bacterial vaginosis by Gram stain criteria , 65 % had symptoms of increased vaginal discharge and /or vaginal malodor , while 74 % had signs of characteristic homogeneous vaginal discharge or amine-like odor . Elevated vaginal pH was the least specific and amine-like odor the least sensitive sign of bacterial vaginosis . Gram stain criteria for bacterial vaginosis were not associated with the concentrations of endocervical or vaginal inflammatory cells but were significantly associated with a clinical diagnosis of pelvic inflammatory disease . After adjusting for coinfection , sexual behavior , and other variables , bacterial vaginosis remained associated with adnexal tenderness ( odds ratio = 9.2 , p = 0.04 ) . Bacterial vaginosis , previously implicated as a risk factor for obstetric infections , may be a risk factor for pelvic inflammatory disease
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 .