Intermittent Lactobacilli-containing Vaginal Probiotic or Metronidazole Use to Prevent Bacterial Vaginosis Recurrence: A Pilot Study Incorporating Microscopy and Sequencing.

Scientific Reports
Janneke H H M van de WijgertAlistair C Darby

Abstract

Bacterial vaginosis (BV) is associated with HIV acquisition and adverse pregnancy outcomes. Recurrence after metronidazole treatment is high. HIV-negative, non-pregnant Rwandan BV patients were randomized to four groups (n = 17/group) after seven-day oral metronidazole treatment: behavioral counseling only (control), or counseling plus intermittent use of oral metronidazole, Ecologic Femi+ vaginal capsule (containing multiple Lactobacillus and one Bifidobacterium species), or Gynophilus LP vaginal tablet (L. rhamnosus 35) for two months. Vaginal microbiota assessments at all visits included Gram stain Nugent scoring and 16S rRNA gene qPCR and HiSeq sequencing. All interventions were safe. BV (Nugent 7-10) incidence was 10.18 per person-year at risk in the control group, and lower in the metronidazole (1.41/person-year; p = 0.004), Ecologic Femi+ (3.58/person-year; p = 0.043), and Gynophilus LP groups (5.36/person-year; p = 0.220). In mixed effects models adjusted for hormonal contraception/pregnancy, sexual risk-taking, and age, metronidazole and Ecologic Femi+ users, each compared to controls, had higher Lactobacillus and lower BV-anaerobes estimated concentrations and/or relative abundances, and were less likely to have a dys...Continue Reading

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Citations

Aug 20, 2020·The New England Journal of Medicine·Thomas E Finucane
Sep 5, 2020·The Journal of Obstetrics and Gynaecology Research·Xinyuan LiangXiaomin Xiao
Jul 3, 2020·Frontiers in Public Health·Rashmi Bagga, Parul Arora
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Aug 20, 2020·The New England Journal of Medicine·Craig R CohenAnke Hemmerling
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Apr 17, 2021·Phytotherapy Research : PTR·Haiyue ZhaoLan Shen
Dec 18, 2020·The Journal of Infectious Diseases·Laurel A LagenaurThomas P Parks

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Methods Mentioned

BETA
PCR
contraception
PCRs

Clinical Trials Mentioned

NCT02459665

Software Mentioned

Ecologic Femi +
STATA
Biose

Related Concepts

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Bacterial Vaginosis

Bacterial vaginosis can increase the risk of sexually transmitted infections and in rare cases lead to pelvic inflammatory diseases. Discover the latest research on Bacterial Vaginosis here.