Long-term vaginal administration of Lactobacillus rhamnosus as a complementary approach to management of bacterial vaginosis

Int J Gynaecol Obstet. 2010 Sep;110(3):223-6. doi: 10.1016/j.ijgo.2010.04.025. Epub 2010 Jun 22.


Objective: To investigate the advantages of long-term vaginal administration of Lactobacillus rhamnosus after oral treatment with metronidazole to prevent the recurrence of bacterial vaginosis (BV).

Methods: A total of 49 women with a diagnosis of BV were randomized into 2 groups. Group A was treated with a twice daily dose of 500 mg oral metronidazole for 7 days. Group B was treated with the same schedule followed by a once-weekly vaginal application of 40 mg of Lactobacillus rhamnosus for 6 months. A non-parametric analysis of variance for repeated measures was used to test whether there were significant changes in the vaginal ecosystems in the 2 groups.

Results: During the first 6 months of follow-up, a constant percentage (96%) of patients in group B had a balanced vaginal ecosystem. Follow-up over 12 months showed no statistically significant difference among vaginal ecosystems in patients in group B (P=0.40), whereas in group A there was a significant increase in the number of women with abnormal flora over time (P=0.01).

Conclusion: The vaginal administration of the probiotic Lactobacillus rhamnosus allows stabilization of the vaginal ecosystem and reduces the recurrence of BV.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Administration, Intravaginal
  • Administration, Oral
  • Adult
  • Anti-Infective Agents / therapeutic use
  • Complementary Therapies
  • Female
  • Humans
  • Lacticaseibacillus rhamnosus*
  • Metronidazole / therapeutic use
  • Probiotics / administration & dosage*
  • Vaginosis, Bacterial / therapy*


  • Anti-Infective Agents
  • Metronidazole