Efficacy of Vitamin C Vaginal Tablets as Prophylaxis for Recurrent Bacterial Vaginosis: A Randomised, Double-Blind, Placebo-Controlled Clinical Trial

Krasnopolsky, Vladislav N.; Prilepskaya, V N; Polatti, Franco; Zarochentseva, N.V.; Bayramova, Guldana R.; Caserini, Maurizio; Palmieri, Renata

doi:10.4021/jocmr1489w

Cited by 20 publications

(21 citation statements)

References 17 publications

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“…In a study by Krasnopolsky et al in treated women, there was no significant difference between BV recurrence based on Amsel criteria 3 months after treatment with 250 mg vitamin C vaginal and placebo group; but this difference was significant 6 months after the treatment (28). In this study, the difference between the 2 groups in terms of BV recurrence 3 months after the treatment was not statistically significant but difference between the 2 groups was significant (14.7% of controls against 6.8% of experimental group).…”

Section: Discussionmentioning

confidence: 88%

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The Addition of Vitamin C Vaginal Tablets to Oral Metronidazole and its Effect on the Treatment and Recurrence of Bacterial Vaginosis: A Randomized Triple-Blind Clinical Trial

Mohammadalizadeh¹,

Dokhanchi²,

Hakimi³

et al. 2017

International Journal of Women’s Health and Reproduction Scienc

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IntroductionVaginitis is an infectious and inflammatory disease that affects vagina and is associated with abnormal vaginal discharge (1). Lactobacilli is the most common vaginal microorganism. The decrease of lactobacilli may lead to symptomatic changes in vagina. Bacterial vaginosis (BV) is the most common vaginitis that is known by a reduction in vaginal lactobacilli and an increased growth of other anaerobic species of bacteria (2). BV can be observed in 64% of women with sexually transmitted infections, 15% to 20% of pregnant women, and 10% to 15% of women who refer to gynecologic clinics (3,4). BV is widespread in different parts of the world and among different ethnicities. For example, it was detected by 5%-15% among Caucasian women and 45%-55% among African and black Americans. It is estimated that the total prevalence of BV around the world is 20%-30%. The prevalence of BV in Iran varies. It is reported by 16% in central, 40% in southern, and 50% in tribes of Iran (among high-risk population) which is a significant value (5-7).BV is a strong risk factor for acquiring and transmission of sexually transmitted diseases, including human immunodeficiency virus (HIV) and pelvic inflammatory disease (8). Moreover, it infects amniotic fluid and fetal membranes and causes premature rupture of membranes during pregnancy and post-partum fever (9,10).The selected treatment of BV is oral metronidazole (11). However, more than half of patients have 2 to 3 recurrences per year (12). BV affects varying degrees of self-confidence and sexual life of women (13). One of the challenges of physicians is to find the effective treatment of BV, because the long-term effectiveness of antibiotics is weak and recurrence is common (13).The aim of BV treatment is to preserve the vaginal pH at 4.5 and lower and to prevent the over growth of pathogens until normal vaginal flora is reconstructed and maintain normal vaginal pH (14,15). The relationship between BV and increased level of vaginal pH has made the use of vagina acidifier materials as an attempt to build an unsuitable area for the growth of pathogens, reasonable (16). One of the effective materials in maintaining vaginal pH lower than 4.5 is vaginal vitamin C; vaginal vitamin C maintains vaginal pH at low range and is effective in treatment of BV through producing lactic acid (17). AbstractObjectives: Bacterial vaginosis (BV) is the most common vaginitis, which is derived from a reduction in vaginal lactobacilli and an increased growth of other anaerobic species of bacteria. Vitamin C can be effective in treatment of BV through the production of lactic acid. The aim of the present study was to determine the efficacy of adding vitamin C vaginal to metronidazole in treatment of BV. Materials and Methods:This study was a triple-blind randomized clinical trial. The study was carried out from July 2015 to November 2015 on 160 women who referred to gynecologic clinic of Mashhad with pure BV. They randomized into intervention and control groups. The intervention group received 500 ...

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Section: Discussionmentioning

confidence: 88%

“…One of treatments of BV is to keep down the acidity of vagina. Anaerobic bacteria will not be able to grow within pH 3.8-4.5 (28). Use of antibiotics for BV treatment would lead to anaerobic bacteria resistance, treatment failure, and recurrence of BV within a few weeks (30).…”

Section: Discussionmentioning

confidence: 99%

The Addition of Vitamin C Vaginal Tablets to Oral Metronidazole and its Effect on the Treatment and Recurrence of Bacterial Vaginosis: A Randomized Triple-Blind Clinical Trial

Mohammadalizadeh¹,

Dokhanchi²,

Hakimi³

et al. 2017

International Journal of Women’s Health and Reproduction Scienc

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“…In addition, the low vaginal pH (< 4.5) caused by the production of lactic acid by members of the genus Lactobacillus tends to suppress the growth of the pathogenic microorganisms that are mainly responsible for vaginal dysbiosis. The vaginal pH is the key factor in the increased incidence of BV in the reproductive age group, and many adjuvant drugs, such as ascorbic acid, Lactobacillus strains, and probiotics, have been investigated to try to decrease vaginal pH and thus reduce the recurrence of BV [49–51]. However, until the pathogenesis of BV is completely understood, treatment will remain unsatisfactory.…”

Section: Discussionmentioning

confidence: 99%

Bacterial biota of women with bacterial vaginosis treated with lactoferrin: an open prospective randomized trial

Pino

Giunta

Randazzo

et al. 2017

Microbial Ecology in Health and Disease

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Background: Bacterial vaginosis is the most frequent condition associated to the vaginal microbiota imbalance, affecting about the 40–50% of women in the world. Even if antibiotics are effcetive for bacterial vaginosis treatment a long-term recurrence rates, higher than 70%, is recorded. Lactoferrin is an iron-binding glycoprotein with bacteriostatic and bactericidal properties. It owns the ability to protect the host against infection, by binding and regulating the iron needed for the bacterial proliferation.Objective: The present study was an open prospective randomized trial (registration no. SHI-EVE-2014.01) aimed at characterizing the bacterial biota of women affected by bacterial vaginosis (BV) and assessing the effects of two different lactoferrin concentrations (100 mg and 200 mg vaginal pessaries) on the composition and dynamics of the vaginal bacterial biota.Design: Sixty women with BV were recruited and randomized into two groups to receive lactoferrin pessaries for 10 days. Clinical evaluation was based on Amsel criteria and Nugent scores. Culture-dependent methods and Ion Torrent PGM sequencing of the 16S rRNA gene were applied to study in depth the overall structure of the vaginal bacterial biota and its dynamics during the treatment.Results: Vaginal lactoferrin administration modified the vaginal microbiota composition in patients with BV. During treatment, both 100 mg and 200 mg lactoferrin vaginal pessaries significantly decreased the occurrence of bacteria associated with BV, such as Gardnerella, Prevotella, and Lachnospira, and increased the occurrence of Lactobacillus species. The bacterial biota balance was maintained up to 2 weeks after treatment only in women treated with 200 mg lactoferrin pessaries.Conclusions: This study indicates that lactoferrin could be proposed as an alternative therapeutic approach for BV. Our data showed, for the first time, the dominance of Lactobacillus helveticus species during and after vaginal lactoferrin treatment.

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“…were reported to be effective both for treatment and prevention of relapses of this infection [49,50] and non-inferior to the local treatment with metronidazole gel [51]. However, other negative clinical results, such as those obtained with a 0.92% acetic acid gel and with lactic acid (100 mg) vaginal suppositories point out the importance of considering the mechanisms of absorption and metabolism of the selected molecules, the concentration of acid applied and the formulation characteristics that influence the acid release and retention in the vaginal cavity as well as the overall buffering capacity [52,53].…”

Section: -Bioadhesive Delivery Systems: Gels Tablets and Filmsmentioning

confidence: 99%

New strategies for local treatment of vaginal infections

Palmeira‐de‐Oliveira

Martinez-de-Oliveira

2015

Advanced Drug Delivery Reviews

155

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Efficacy of Vitamin C Vaginal Tablets as Prophylaxis for Recurrent Bacterial Vaginosis: A Randomised, Double-Blind, Placebo-Controlled Clinical Trial

Cited by 20 publications

References 17 publications

The Addition of Vitamin C Vaginal Tablets to Oral Metronidazole and its Effect on the Treatment and Recurrence of Bacterial Vaginosis: A Randomized Triple-Blind Clinical Trial

The Addition of Vitamin C Vaginal Tablets to Oral Metronidazole and its Effect on the Treatment and Recurrence of Bacterial Vaginosis: A Randomized Triple-Blind Clinical Trial

Bacterial biota of women with bacterial vaginosis treated with lactoferrin: an open prospective randomized trial

New strategies for local treatment of vaginal infections

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