Randomised clinical trial in women with Recurrent Vulvovaginal Candidiasis: Efficacy of probiotics and lactoferrin as maintenance treatment

Mycoses. 2019 Apr;62(4):328-335. doi: 10.1111/myc.12883. Epub 2019 Feb 20.


Background: Vulvovaginal candidiasis (VVC) is a recurrent vaginal condition in childbearing women.

Objectives: The aim of this study was to assess the efficacy of an oral formulation containing Lactobacillus acidophilus GLA-14, Lactobacillus rhamnosus HN001 and bovine lactoferrin on symptoms and recurrence of VVC as adjuvant therapy to topical clotrimazole.

Patients/methods: Forty-eight women positive for C. albicans, symptoms of VVC and documented history of recurrences were randomised into 2 groups receiving verum or placebo (2 capsules/day for 5 days followed by 1 capsule/day for additional 10 days) as adjuvant treatment to clotrimazole (induction phase) followed by a maintenance cycle of 6 months (1 capsule/day verum or placebo for 10 consecutive days each month). Symptoms, overall cure rate and recurrence rate were assessed.

Results: After clotrimazole therapy, a significant improvement of symptoms was shown in both groups. However, only women treated with probiotics and lactoferrin showed a significant improvement of itching and discharge at 3 and 6 months. During the six-month follow-up, recurrences were significantly less in the intervention group vs placebo (33.3% vs 91.7% after 3 months and 29.2% vs 100% after 6 months).

Conclusions: The results show that the investigated lactobacilli mixture in combination with lactoferrin represents a safe and effective adjuvant approach for reducing symptoms and recurrences of RVVC.

Keywords: Lactobacillus acidophilus; Lactobacillus rhamnosus; Bovine lactoferrin; Candida spp.; Respecta®; vulvovaginal infections.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adolescent
  • Adult
  • Animals
  • Anti-Infective Agents / administration & dosage*
  • Candidiasis, Vulvovaginal / drug therapy*
  • Candidiasis, Vulvovaginal / pathology
  • Chemoradiotherapy, Adjuvant / methods
  • Clotrimazole / administration & dosage*
  • Double-Blind Method
  • Female
  • Humans
  • Lactoferrin / administration & dosage*
  • Maintenance Chemotherapy / methods
  • Middle Aged
  • Placebos / administration & dosage
  • Probiotics / administration & dosage*
  • Prospective Studies
  • Secondary Prevention / methods*
  • Treatment Outcome
  • Young Adult


  • Anti-Infective Agents
  • Placebos
  • Lactoferrin
  • Clotrimazole

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