title: Use of a lactic acid plus lactoserum intimate liquid soap for external hygiene in the prevention of bacterial vaginosis recurrence after metronidazole oral treatment.
abstract: OBJECTIVE
  To determine the recurrence of bacterial vaginosis (BV) after the use of a lactic acid plus lactoserum liquid soap starting immediately after the treatment with oral metronidazole and the quality of life of the participants.
  
  
  METHODS
  A total of 123 women with diagnosis of BV with at least three of the following criteria: 1) homogeneous vaginal discharge without inflammation of the vagina or vulva; 2) vaginal pH ≥ 4.5; 3) positive Whiff test; and 4) "clue cells" in more than 20% of the epithelial cells in the vagina. A Nugent score ≥ 4 in the vaginal bacterioscopy was also used. After BV diagnosis, metronidazole 500 mg was administered orally bid during 7 days. Patients cured of BV were then instructed to use 7.5 to 10 mL of a lactic acid plus lactoserum liquid soap once-a-day for hygiene of the external genital region. Three subsequent control visits after starting the hygiene treatment (30, 60, and 90 days; ± 5 days) were scheduled. A questionnaire was applied in the form of visual analogue scale (VAS) in all the visits regarding: 1) level of comfort at the genital region; 2) malodorous external genitalia; 3) comfort in sexual intercourse; 4) satisfaction with intimate hygiene; and 5) self-esteem.
  
  
  RESULTS
  Ninety two (74.8%) women initiated the use of a lactic acid plus lactoserum liquid soap at visit 1. At visit 2, 3, and 4 there were 84, 62 and 42 women available for evaluation, respectively. The rate of recurrence of BV was 19.0%, 24.2% and 7.1%, respectively in the three visits and vaginal candidiasis was observed in five treated women. Quality of life was evaluated in the 42 women who completed the four visits schedule and there were significant improvement in the five domains assessed.
  
  
  CONCLUSIONS
  A lactic acid plus lactoserum liquid soap for external intimate hygiene may be an option for the prevention of BV recurrence after treatment and cure with oral metronidazole.
authors.affiliation: Human Reproduction Unit, Department of Obstetrics and Gynecology, Medical School, Universidade Estadual de Campinas (UNICAMP) and National Institute of Hormones and Women Health, Campinas, SP, Brazil.
authors.forename: M Valeria
authors.initials: MV
authors.lastname: Bahamondes
authors.forename: Priscila Mendes
authors.initials: PM
authors.lastname: Portugal
authors.forename: Eliane Melo
authors.initials: EM
authors.lastname: Brolazo
authors.forename: José Antônio
authors.initials: JA
authors.lastname: Simões
authors.forename: Luis
authors.initials: L
authors.lastname: Bahamondes
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D053566:Hygiene Products; D006801:Humans; D006920:Hygiene; D007106:Immune Sera; D019344:Lactic Acid / Q000627:therapeutic use*; D008795:Metronidazole / Q000627:therapeutic use*; D008875:Middle Aged; D011788:Quality of Life; D055502:Secondary Prevention; D012915:Soaps / Q000627:therapeutic use*; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome; D014621:Vagina / Q000382:microbiology; D016585:Vaginosis, Bacterial / Q000188:drug therapy* / Q000517:prevention & control*; D016387:Women's Health; D055815:Young Adult
chemical_list: D053566:Hygiene Products; D007106:Immune Sera; D019344:Lactic Acid; D008795:Metronidazole; D012915:Soaps; C018577:lactoserum