title: Lactobacillus plantarum P17630 for preventing Candida vaginitis recurrence: a retrospective comparative study.
abstract: BACKGROUND
  Recurrence is a frequent complaint of patients with vulvovaginal candidiasis (VVC). Although the pathogenesis of VVC remains a controversial issue, disruption of the balance between the vaginal microbiota may facilitate overgrowth by Candida. Some probiotic bacterial strains can suppress Candida albicans; Lactobacillus plantarum P17630 is able to attach to vaginal epithelial cells and significantly reduce the adhesion of C. albicans.
  
  
  OBJECTIVE
  To evaluate the effect of the application of Lactobacillus plantarum P17630 in restoring the vaginal microbiota and prevention of relapses among women with acute VVC undergoing conventional (azole) local and main therapy.
  
  
  METHODS
  Retrospective comparative study. We recruited 89 women with a diagnosis of VVC, who were placed into two groups on the basis of reported treatment. The control group was treated with a daily dose of 2% clotrimazole vaginal cream at bedtime for 3 days, followed by vaginal application of a capsule containing lubricant once a day for 6 days and then once a week for another 4 weeks. The probiotic group was treated with the same azole-based protocol but followed by vaginal application of a capsule containing Lactobacillus plantarum P17630 (>10₈ CFU) once a day for 6 days and then once a week for another 4 weeks beginning the day following clotrimazole discontinuation. Clinical and diagnostic patterns were monitored for three months of follow-up.
  
  
  RESULTS
  At the end of study the probiotic-treated women showed a statistically significant increase in Lactobacillus values "+++" (80% versus 40%, p<0.001) and a better subjective resolution of symptoms such as vaginal discomfort described as burning or itching (90% versus 67.5%, p<0.03). Among controls there was a non-significant increase at 3 months of recurrence of infection, but a significant increase of women with value of pH=5 or >5.
  
  
  CONCLUSIONS
  Although the results of different studies are controversial, most have suggested use of probiotics in the prevention or treatment of VVC, and no adverse effects have been reported. Our data with L. plantarum P17630 (Gyno-Canesflor - Bayer) confirm the role of this specific strain as a potential empirical preventive agent for reducing vaginal discomfort after conventional treatment of acute VVC and shifting the vaginal milieu toward a predominance of lactobacilli with an improvement of the vaginal pH value.
authors.affiliation: Institute for Maternal and Child Health-IRCCS "Burlo Garofolo", University of Trieste, 34137 Trieste, Italy. Electronic address: fradeseta@gmail.com.
authors.forename: F
authors.initials: F
authors.lastname: De Seta
authors.affiliation: Dipartimento di Scienze Cliniche e di Comunità, University of Milan, Milano, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Parazzini
authors.affiliation: Institute for Maternal and Child Health-IRCCS "Burlo Garofolo", University of Trieste, 34137 Trieste, Italy.
authors.forename: R
authors.initials: R
authors.lastname: De Leo
authors.affiliation: Institute for Maternal and Child Health-IRCCS "Burlo Garofolo", University of Trieste, 34137 Trieste, Italy.
authors.forename: R
authors.initials: R
authors.lastname: Banco
authors.affiliation: Institute for Maternal and Child Health-IRCCS "Burlo Garofolo", University of Trieste, 34137 Trieste, Italy.
authors.forename: G P
authors.initials: GP
authors.lastname: Maso
authors.affiliation: Institute for Maternal and Child Health-IRCCS "Burlo Garofolo", University of Trieste, 34137 Trieste, Italy.
authors.forename: D
authors.initials: D
authors.lastname: De Santo
authors.affiliation: Institute for Maternal and Child Health-IRCCS "Burlo Garofolo", University of Trieste, 34137 Trieste, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Sartore
authors.affiliation: Institute for Maternal and Child Health-IRCCS "Burlo Garofolo", University of Trieste, 34137 Trieste, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Stabile
authors.affiliation: Institute for Maternal and Child Health-IRCCS "Burlo Garofolo", University of Trieste, 34137 Trieste, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Inglese
authors.affiliation: Institute for Maternal and Child Health-IRCCS "Burlo Garofolo", University of Trieste, 34137 Trieste, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Tonon
authors.affiliation: Institute for Maternal and Child Health-IRCCS "Burlo Garofolo", University of Trieste, 34137 Trieste, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Restaino
mesh_terms: D000282:Administration, Intravaginal; D000293:Adolescent; D000328:Adult; D000935:Antifungal Agents / Q000627:therapeutic use; D002181:Candidiasis, Vulvovaginal / Q000517:prevention & control*; D003022:Clotrimazole / Q000627:therapeutic use; D005260:Female; D006801:Humans; D048191:Lactiplantibacillus plantarum; D064307:Microbiota; D008875:Middle Aged; D019936:Probiotics / Q000008:administration & dosage*; D012008:Recurrence; D012189:Retrospective Studies; D055502:Secondary Prevention / Q000379:methods*; D014621:Vagina / Q000382:microbiology*; D014622:Vaginal Creams, Foams, and Jellies / Q000627:therapeutic use; D055815:Young Adult
chemical_list: D000935:Antifungal Agents; D014622:Vaginal Creams, Foams, and Jellies; D003022:Clotrimazole
keywords: Lactobacillus plantarum P17630; Probiotic; Vulvovaginal candidiasis