816 Probiotics In The Prophylaxis And Treatment Of Bacterial Vaginosis

Sousa L, Xavier R, Nunes M
Aim: Bacterial vaginosis (BV) is one of the main causes of genital discomfort in women. In its origin, there’s a change in the vaginal flora, with the replacement of normally dominant and protector lactobacilli by other bacterial agents, especially anaerobic. Due to its possible severe gynaecological and obstetric complications, the adequate management of this pathology is crucial. These factors associated to the high rate of treatment failure and recurrences with the antibiotics normally used, have promoted the study of probiotics as possible solutions for the prophylaxis and treatment of BV. Our goal is to evaluate the evidence available for the use of probiotics in the prevention and treatment of BV.
Material and methods: A search was conducted in Cochrane Library, Bandolier, TRIP, DARE, Pubmed and NGC using the MESH terms: probiotics and bacterial vaginosis. The research was limited to articles published in the last 10 years in Portuguese, English or Spanish. To evaluate the evidence we used the Strength Of Recommendation Taxonomy (SORT) scale of American Family Physician.
Results: Three systematic reviews, one evidence-based review, three clinical trials and two guidelines filled in the search criteria. The use of oral probiotics including Lactobacillus rhamnosus GR + Lactobacillus reuteri RC14 after treatment with nitroimidazoles (metronidazole, tinidazole) has a SOR C for the treatment of BV. We found multiple studies with different methodologies that evaluated several different strains of lactobacillus, therapeutic regimens, administration options, outcomes and associations, that didn’t allow us to prove or unprove its efficiency in the prevention and treatment of bacterial vaginosis (SOR C).
Conclusions: The evidence supporting the use of probiotics in the prevention and treatment of BV is scarce, and more randomised controlled studies using standard methodologies and larger samples that evaluate strains and doses of probiotics with proven efficacy are advised.
Probiotics in the prophylaxis and treatment of bacterial vaginosis