Long-term vaginal administration of Lactobacillus rhamnosus as a complementary approach to management of bacterial vaginosis.
OBJECTIVE
To investigate the advantages of long-term vaginal administration of Lactobacillus rhamnosus after oral treatment with metronidazole to prevent the recurrence of bacterial vaginosis (BV).


METHODS
A total of 49 women with a diagnosis of BV were randomized into 2 groups. Group A was treated with a twice daily dose of 500 mg oral metronidazole for 7 days. Group B was treated with the same schedule followed by a once-weekly vaginal application of 40 mg of Lactobacillus rhamnosus for 6 months. A non-parametric analysis of variance for repeated measures was used to test whether there were significant changes in the vaginal ecosystems in the 2 groups.


RESULTS
During the first 6 months of follow-up, a constant percentage (96%) of patients in group B had a balanced vaginal ecosystem. Follow-up over 12 months showed no statistically significant difference among vaginal ecosystems in patients in group B (P=0.40), whereas in group A there was a significant increase in the number of women with abnormal flora over time (P=0.01).


CONCLUSIONS
The vaginal administration of the probiotic Lactobacillus rhamnosus allows stabilization of the vaginal ecosystem and reduces the recurrence of BV.
Marcone
Valentina
V
Cervico-Vaginal Pathology Unit, Department of Gynecology and Obstetrics, Sapienza University, Rome, Italy. valentina.marcone@uniroma1.it
Rocca
Giuseppe
G
Lichtner
Miriam
M
Calzolari
Ettore
E
D000282:Administration, Intravaginal; D000284:Administration, Oral; D000328:Adult; D000890:Anti-Infective Agents / Q000627:therapeutic use; D000529:Complementary Therapies; D005260:Female; D006801:Humans; D052201:Lacticaseibacillus rhamnosus; D008795:Metronidazole / Q000627:therapeutic use; D019936:Probiotics / Q000008:administration & dosage*; D016585:Vaginosis, Bacterial / Q000628:therapy*
D000890:Anti-Infective Agents; D008795:Metronidazole