The use of Lactobacillus rhamnosus in the therapy of bacterial vaginosis. Evaluation of clinical efficacy in a population of 40 women treated for 24 months

Arch Gynecol Obstet. 2010 Jun;281(6):1065-9. doi: 10.1007/s00404-009-1287-6. Epub 2009 Dec 12.

Abstract

Background: Bacterial vaginosis (BV) is the most prevalent vaginal disorder in adult women worldwide. A number of clinical studies indicate that re-establishment of the physiological ecosystem by re-colonization of vaginal mucosa by lactobacilli may be an effective therapy for BV both after initial antimicrobial therapy or when given alone. A vaginal pH <4.5 is considered physiological and its measurement has been reported as an objective parameter, very sensitive to alterations of vaginal microflora and correlated with clinically relevant BV.

Objective: The aims of this work were to assess the effectiveness of a long-term (24 months) intravaginal treatment with Lactobacillus rhamnosus (NORMOGIN) on the vaginal pH and on the clinical symptoms in a group of 40 women affected by BV diagnosed by the Amsel criteria.

Method: A prospective open clinical trial was performed in 40 consecutive cases evaluated for B.V. by the Amsel criteria.

Results: Vaginal pH was above the physiological value of 4.5 in 36 out of 40 patients at the first visit. It returned under 4.5 value in 24/40 and 32/40 women after 12 and 24 months of treatment, respectively. pH values were significantly decreased at 12 month treatment (P < 0.001) and further reduction in pH values was found at 24 months of treatment (P < 0.02 vs. 12 months). The gradual return to a vaginal physiological pH was associated with a reduction of the intensity of symptoms as shown by the decrease in the symptoms score.

Conclusions: The present study supports the use of pH measurement for sensitive, objective, and simple therapy follow-up in women with BV and shows that long-term administration of vaginal tablets containing Lactobacillus rhamnosus represents an effective and safe treatment for restoring the physiological vaginal pH and controlling BV symptoms.

Publication types

  • Clinical Trial

MeSH terms

  • Administration, Intravaginal
  • Adult
  • Aged
  • Female
  • Humans
  • Hydrogen-Ion Concentration
  • Lactobacillus rhamnosus*
  • Middle Aged
  • Probiotics / administration & dosage*
  • Prospective Studies
  • Treatment Outcome
  • Vaginosis, Bacterial / therapy*
  • Young Adult