Objective: a survey of effective natural compounds and probiotics with antifungal activity and their possible use in vulvovaginitis as a prophylactic or therapeutic drug.
Design: review of literature.
Setting: Charles University at Prague, Pharmaceutical Faculty at Hradec Kralove.
Methods: and review of literature and publications from medical data-bases.
Conclusions: certain natural compounds were proved to exert antimycotic effects. The efficiency of garlic extract under in vitro conditions against yeast of C. albicans family becomes manifest within one hour. Essential oils present in the Cayenne pepper (Capsodum frutescens) exert considerable antifungal activity against C. albicans as well. Clove exerts lower antimycotic effects. The effects of Chinese leek are similar to garlic. Propolis also possesses antifungal properties, and sensitivity of the yeast strains decreases in the following order: C. albicans > C. tropicalis > C. crusei > C. guilliermondii. Its efficiency depends on the composition and place of origin. Tea trea oil (Melalauca alternifolia) is inhibiting strains of Candida family (genus) in minimal inhibiting concentration, higher concentrations are necessary for C. crusei and C. norvengensis. In the prophylaxis of vaginal candidoses, oral administration of the strains of Lactobacilus rhamnosus GR-1 and L. fermentum RC-14, B-54 may be recommended. Moreover there are suitable strains of L. brevis CD-2, L. salivarius FV-2, L. gasseri MB 335, L. plantarum, useful in the form of gel capsules (L. plantarum) or vaginal tablets (L. gasseri). The strains of L. acidophilus CRL 1294 and L. salivarius CRL 1328 display the capacity of self aggregation and co-aggregation with Candida. It should be pointed out that the probiotic strain of Lactobacillus (especially L. casei and L. rhamnosus) may, in exceptional cases, cause bacteriemia and sepsis, especially in immunodeficient patients and those who underwent surgery of alimentary tract. No protective effect against yeast infection was detected with vitamin E, any positive effect was not unequivocally confirmed with zinc, but adjusting zinc levels to normal may be recommended.