Probiotic interventions were effective for treatment and prevention of BV , prevention of recurrences of c and idiasis and UTIs , and clearing HPV lesions .
Although clinical practice recommendations were limited by the strength of evidence , probiotic interventions were effective in treatment and prevention of urogenital infections as alternatives or co-treatments .
INTRODUCTION Probiotics are a complementary and integrative therapy useful in the treatment and prevention of urogenital infections in women .
This study extends the work of research ers who systematic ally investigated the scientific literature on probiotics to prevent or treat urogenital infections .
Effectiveness of the Two Microorganisms Lactobacillus fermentum LF15 and Lactobacillus plantarum LP01, Formulated in Slow-release Vaginal Tablets, in Women Affected by Bacterial Vaginosis: A Pilot Study
Background : Bacterial vaginosis ( BV ) is the most common reason for abnormal vaginal discharge in reproductive-age women and one of its most important causative agents is the gram-variable bacterium Gardnerella vaginalis . BV is not accompanied by significant local inflammation , whereas the “ fishy odor ” test is always positive . In contrast , aerobic vaginitis ( AV ) is predominantly associated with Escherichia coli , but Streptococcus agalactiae and Staphylococcus aureus are also involved . St and ard treatment of BV consists of oral or intravaginal antibiotics , although these are unable to spontaneously restore normal flora characterized by a high concentration of lactobacilli . The main limitation is the inability to offer a long-term defensive barrier , thus facilitating relapses and recurrences . This study was undertaken firstly to assess the ability of selected lactobacilli to in vitro antagonize G. vaginalis to determine an association with a strain able to inhibit E. coli , thus identifying a possible use in AV . The second step of the study was to conduct a human pilot trial in women affected by BV using an association of the most promising and active bacteria . Material s and Methods : For this purpose , neutralized supernatants of individual lactobacilli were tested at percentages ranging from 0.5 % to 4 % to determine their ability to hinder the growth of G. vaginalis American Type Culture Collection 10231 . The bacterium that was able to exert the strongest inhibition was subsequently tested with Lactobacillus plantarum LP01 in a human intervention , placebo-controlled , pilot trial involving 34 female subjects ( aged between 18 and 50 , mean 34.7±8.9 , no menopausal women ) diagnosed with BV . The 2 microorganisms Lactobacillus fermentum LF15 ( DSM 26955 ) and L. plantarum LP01 ( LMG P-21021 ) were delivered to the vagina by means of slow-release vaginal tablets , also containing 50 mg of tara gum . The amount of each strain was 400 million live cells per dose . The women were instructed to apply a vaginal tablet once a day for 7 consecutive nights , followed by 1 tablet every 3 nights for a further 3-week application ( acute phase ) and , finally , 1 tablet per week to maintain a long-term vaginal colonization against possible recurrences . A clinical examination was performed and the Nugent score was quantified for each patient at enrollment ( d0 ) , after 28 days ( d28 ) , and at the end of the second month of relapse prevention ( d56 ) . A statistical comparison was made between d28 , or d56 , and d0 , and between d56 and d28 to quantify the efficacy against possible recurrences . Results : L. fermentum LF15 showed the strongest in vitro inhibitory activity towards G. vaginalis American Type Culture Collection ( ATCC ) 10231 after both 24 and 48 hours . In the human trial , the 2 lactobacilli selected , namely L. fermentum LF15 and L. plantarum LP01 , significantly reduced the Nugent score below the threshold of 7 after 28 days in 22 patients of 24 in the active group ( 91.7 % , P<0.001 ) . Eight women ( 33.3 % ) recorded a Nugent score between 4 and 6 , evidence of an intermediate situation , whereas the remaining 14 ( 58.3 % ) showed a score < 4 , therefore suggesting the restoration of physiological vaginal microbiota . At the end of the second month , only 4 women registered a Nugent score > 7 , definable as BV ( 16.7 % , P=0.065 compared with d28 ) . In the placebo group , no significant differences were recorded at any time . Conclusions : BV , also known as vaginal bacteriosis is the most common cause of vaginal infection in women of childbearing age . Furthermore , BV is often asymptomatic as about 50 % of women with this condition have no symptoms at all and the prevalence rate in apparently healthy women is around 10 % . This study suggests the ability of the 2 strains L. fermentum LF15 and L. plantarum LP01 to counteract acute Gardnerella infections effectively and significantly improve the related uncomfortable symptoms in a very high percentage of women . This could be partially attributed to the presence of tara gum , which is able to create a mechanical barrier against Gardnerella on the surface of vaginal mucosa as a primary mechanism . Furthermore , long-term physiological protection seems to be established , thanks to the integration of the 2 lactobacilli into the vaginal microbiota and to their adhesion to the epithelial cells of the mucosa . In the light of the additional in vitro inhibitory activity against E. coli , their prospect i ve use in AV could also prove interesting
Probiotic interventions were effective for treatment and prevention of BV , prevention of recurrences of c and idiasis and UTIs , and clearing HPV lesions .
Although clinical practice recommendations were limited by the strength of evidence , probiotic interventions were effective in treatment and prevention of urogenital infections as alternatives or co-treatments .
INTRODUCTION Probiotics are a complementary and integrative therapy useful in the treatment and prevention of urogenital infections in women .
This study extends the work of research ers who systematic ally investigated the scientific literature on probiotics to prevent or treat urogenital infections .