title: [Effect of Lactobacillus casei var rhamnosus (Gynophilus) in restoring the vaginal flora by female patients with bacterial vaginosis--randomized, open clinical trial].
abstract: The vaginal probiotics can increase the clinical and microbiological efficacy of the therapeutic regimens used for the treatment of bacterial vaginosis. The Aim of our study was to evaluate the effect of the application of Lactobacillus casei var rhamnosus (Gynophilus--probiotic species Lcr 35) in restoring the vaginal flora and prevention of relapses by female patients with anaerobic vaginal infection undergoing conventional (nitroimidazole) local and main therapy.
  
  
  METHODS
  In the study were included 60 women with established Amsel/Nugent bacterial vaginosis who were randomized in two groups. The first group patients (n-30 beginning/n-25 controls) underwent a 5 day treatment with two daily peroral doses of metronidazole 500 mg, with local application of metronidazole ovules 1000 mg at the 1st and the 3rd day (M+M). In the second group (n-30 beginning/n-26 controls) the therapeutic regimen was the same as in the first group, with additional 7 day treatment with Lactobacillus casei var rhamnosus - Lcr 35. (Gynophilus) vaginal ovules, two daily doses (M+M+G).
  
  
  RESULTS
  30% to 40% was the difference/enhance of the clinical efficacy according to the clinical indicators when Lactobacillus casei var rhamnosus - Lcr 35 was added to the standard nitroimidazole therapy. Concerning the main clinical indicator: Amsel criteria, the improvement after the therapy in the first group (M+M) was 60% (n-15) and in the second group (M+M+G) 88.5% (n-23). According to the microbiological indicators the improvement in the first group (M+M) based on the vaginal flora evaluation (Nugent score) was 60% (n-15) and in the second group, after the addition of Lcr 35 it was 88.5% (n-23).
  
  
  CONCLUSIONS
  The application of Gynophilus after conventional 5-nitroimidazole treatment for bacterial vaginosis increased the clinical and microbiological efficacy of the therapy by 25% - 30%. The microbial balance in the vaginal ecosystem was restored in the majority of patients (88%), which is a prerequisite for low percentage of bacterial vaginosis relapses.
authors.forename: S
authors.initials: S
authors.lastname: Kovachev
authors.forename: R
authors.initials: R
authors.lastname: Dobrevski-Vacheva
mesh_terms: D000293:Adolescent; D000328:Adult; D000890:Anti-Infective Agents / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007780:Lacticaseibacillus casei / Q000502:physiology; D052201:Lacticaseibacillus rhamnosus / Q000502:physiology; D008795:Metronidazole / Q000627:therapeutic use*; D008875:Middle Aged; D019936:Probiotics / Q000627:therapeutic use*; D014621:Vagina / Q000382:microbiology*; D016585:Vaginosis, Bacterial / Q000382:microbiology / Q000628:therapy*; D055815:Young Adult
chemical_list: D000890:Anti-Infective Agents; D008795:Metronidazole