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 .
Efficacy of Oral Metronidazole with Vaginal Clindamycin or Vaginal Probiotic for Bacterial Vaginosis: Randomised Placebo-Controlled Double-Blind Trial
Background To determine if oral metronidazole ( MTZ-400 mg bid ) with 2 % vaginal clindamycin-cream ( Clind ) or a Lactobacillus acidophilus vaginal-probiotic containing oestriol ( Prob ) reduces 6-month bacterial vaginosis ( BV ) recurrence . Methods Double-blind placebo-controlled parallel-group single-site study with balanced r and omization ( 1∶1∶1 ) conducted at Melbourne Sexual Health Centre , Australia . Participants with symptomatic BV [ Nugent Score ( NS ) = 7–10 or ≥3 Amsel 's criteria and NS = 4–10 ] , were r and omly allocated to MTZ-Clind , MTZ-Prob or MTZ-Placebo and assessed at 1,2,3 and 6 months . MTZ and Clind were administered for 7 days and Prob and Placebo for 12 days . Primary outcome was BV recurrence ( NS of 7–10 ) on self-collected vaginal-swabs over 6-months . Cumulative BV recurrence rates were compared between groups by Chi-squared statistics . Kaplan-Meier , log rank and Cox regression analyses were used to compare time until and risk of BV recurrence between groups . Results 450 18–50 year old females were r and omized and 408 ( 91 % ) , equally distributed between groups , provided ≥1 NS post-r and omization and were included in analyses ; 42 ( 9 % ) participants with no post-r and omization data were excluded . Six-month retention rates were 78 % ( n = 351 ) . One-month BV recurrence ( NS 7–10 ) rates were 3.6 % ( 5/140 ) , 6.8 % ( 9/133 ) and 9.6 % ( 13/135 ) in the MTZ-Clind , MTZ-Prob and MTZ-Placebo groups respectively , p = 0.13 . Hazard ratios ( HR ) for BV recurrence at one-month , adjusted for adherence to vaginal therapy , were 0.43 ( 95%CI 0.15–1.22 ) and 0.75 ( 95 % CI 0.32–1.76 ) in the MTZ-Clind and MTZ-Prob groups compared to MTZ-Plac respectively . Cumulative 6-month BV recurrence was 28.2 % ; ( 95%CI 24.0–32.7 % ) with no difference between groups , p = 0.82 ; HRs for 6-month BV recurrence for MTZ-Clind and MTZ-Prob compared to MTZ-Plac , adjusted for adherence to vaginal therapy were 1.09(95 % CI = 0.70–1.70 ) and 1.03(95 % CI = 0.65–1.63 ) , respectively . No serious adverse events occurred . Conclusion Combining the recommended first line therapies of oral metronidazole and vaginal clindamycin , or oral metronidazole with an extended-course of a commercially available vaginal-L.acidophilus probiotic , does not reduce BV recurrence . Trial Registration ANZCTR.org.au
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 .