title: Activity of a Lactobacillus acidophilus-based douche for the treatment of bacterial vaginosis.
abstract: OBJECTIVE
  Bacterial vaginosis is characterized by alteration of the normal vaginal microflora, in which a mixed anaerobic bacterial flora becomes prevalent over the population of lacobacilli. Because administration of probiotics might be of some utility in restoring a normal flora, the present study aimed to evaluate the effect of a Lactobacillus acidophilus-strain-based douche on the vaginal environment in bacterial vaginosis.
  
  
  METHODS
  In an open-label pilot evaluation, 40 women with bacterial vaginosis as defined by Amsel's criteria were treated for 6 days with a douche containing L. acidophilus. Vaginal smears were collected from the patients and analyzed according to Nugent's criteria at the time of diagnosis, after 6 days of treatment, and again at 20 days after the last treatment. At the same times, determination of vaginal pH and a Whiff test were performed.
  
  
  RESULTS
  The Nugent score decreased significantly from bacterial vaginosis or an intermediate flora toward a normal flora during treatment, and remained low during the follow-up period for almost all of the patients, indicating bacterial vaginosis in 52.5% and in 7.5% of the patients before treatment and at follow-up, respectively. After treatment, significant decreases in vaginal pH were observed, to less than pH 4.5 in 34/40 women, and the odor test became negative in all of the patients.
  
  
  CONCLUSIONS
  In this preliminary study, treatment of bacterial vaginosis with a vaginal douche containing a strain of L. acidophilus contributed to the restoration of a normal vaginal environment.
authors.affiliation: Laboratory of Clinical Microbiology, Department of Preclinical Sciences LITA Vialba, University of Milan, Milan, Italy. lorenzo.drago@unimi.it
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Drago
authors.forename: Elena
authors.initials: E
authors.lastname: De Vecchi
authors.forename: Lucia
authors.initials: L
authors.lastname: Nicola
authors.forename: Elisa
authors.initials: E
authors.lastname: Zucchetti
authors.forename: Maria Rita
authors.initials: MR
authors.lastname: Gismondo
authors.forename: Franco
authors.initials: F
authors.lastname: Vicariotto
mesh_terms: D000282:Administration, Intravaginal; D003944:Diagnostic Techniques, Obstetrical and Gynecological; D005260:Female; D006801:Humans; D007779:Lactobacillus acidophilus; D008875:Middle Aged; D010865:Pilot Projects; D019936:Probiotics / Q000627:therapeutic use*; D015203:Reproducibility of Results; D012107:Research Design; D016896:Treatment Outcome; D044364:Vaginal Douching / Q000379:methods*; D014626:Vaginal Smears; D016585:Vaginosis, Bacterial / Q000628:therapy*; D016387:Women's Health