[Probiotic monotherapy of bacterial vaginosis: a open, randomized trial]

Abstract

The aim of the current research is to establish the clinical and microbiological efficacy of the therapy with local probiotics in the treatment of anaerobic vaginal infections and the therapy's effect upon vaginal flora.

Study design/methods: 381 (100%) women with bacterial vaginitis are included in the research. They were randomized into three groups. In the first group 143 women who were treated with local (10 applications) probiotics vaginal medicine, containing live lactobacillus types Lactobacillus acidophilus, Lactobacillus rhamnosus. In the second group 126 patients were treated with five days oral administration of Clindamycin (tabl.x 600 mg) BID and local therapy of two vaginal ovules containing each 1000 mg Metronidazole, which were administered intravaginal every other day. In the third group 112 women were treated with the same therapy as the second group and in addition started from the day 5 after it were administered locally probiotic medicine containing Lactobacillus acidophilus u Lactobacillus rhamnosus. The efficacy of the therapeutic scheme was evaluated via comparison of patients' clinical complains in the different groups, of data from clinical examinations (Amsel) and microbiological tests (Nugent) for each patient.

Results: Thirty five-forty days after the probiotic therapy, the clinical efficacy in this group (Amsel) is 42.7% and microbiological efficacy (Gram preparation - Nugent)--41.3%. They are lower than the results which we received in the groups where the combine nitroimidazole/incozamide treatment was performed with or without local probiotic. The second group: clinical efficacy--51.6%, microbiological (Nugent)--46.4%. The highest clinical--87.5% and microbiological--80.3% efficacy showed the combine nitroimidazole/lincozamide/probiotic treatment in the third group.

Conclusions: Our results show that the local monotherapy with probiotics has fewer efficacies in comparison to the combine therapeutic schemes for treatment of vaginal disbacteriosis with dominant anaerobic species.