Long‐term vaginal administration of <i>Lactobacillus rhamnosus</i> as a complementary approach to management of bacterial vaginosis

Marcone, Valentina; Rocca, Giuseppe; Lichtner, Miriam; Calzolari, E

doi:10.1016/j.ijgo.2010.04.025

Cited by 61 publications

(31 citation statements)

References 16 publications

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“…Alteration of the vaginal Xora may result in development of bacterial vaginosis [14] or in the more recently identiWed aerobic vaginitis [15] and the use of preparations containing lactobacilli as probiotics has been shown to be beneWcial in preventing the growth of pathogenic microorganisms and in reducing the occurrence of altered vaginal Xora in women [16][17][18][19].…”

Section: Introductionmentioning

confidence: 99%

Normal vaginal flora, disorders and application of probiotics in pregnancy

Stojanovic

Plecas

Plešinac

2012

Arch Gynecol Obstet

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Section: Introductionmentioning

confidence: 99%

Normal vaginal flora, disorders and application of probiotics in pregnancy

Stojanovic

Plecas

Plešinac

2012

Arch Gynecol Obstet

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“…Lactobacilli are the primary organisms in the vaginas of healthy women. Their colonisation of the vagina has been shown to reduce the incidence of bacterial vaginosis, yeast vaginitis, urinary tract infections and sexually transmitted diseases (Ehrstrom et al, 2010;Marcone et al, 2010;Reid, 2008;Reid & Bocking, 2003;Zarate & Nader-Macias, 2006). …”

Section: Probioticsmentioning

confidence: 99%

“…Studies continues to support the positive potential of probiotics to modulate the vaginal microbiota. It will be interesting to discover which strain or combination of strains emerge as the best choice for vaginal health through future research (Ehrstrom et al, 2010;Marcone et al, 2010;Stojanovic et al, 2012;Vitali et al, 2012;Wang et al, 2010).…”

Section: Incorrect Strain Of Probioticmentioning

confidence: 99%

The impact of oral probiotics on vaginal Group B Streptococcal colonisation rates in pregnant women: A pilot randomised control study

et al. 2018

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AimThe aim of this study was to complete a pilot project to ascertain if the research design was appropriate to determine whether a daily oral dose of probiotics can reduce the rate of vaginal group B streptococcal (GBS) colonisation in pregnancy. MethodologyA pilot randomised controlled trial was performed which recruited 34 GBS-positive women who were approximately 36 weeks pregnant. The participants were randomly allocated to the control group, who continued with standard antenatal care, or to the intervention group, which continued with standard antenatal care and received a daily oral dose of probiotics for three weeks or until the birth of their infant. A lower vaginal swab to detect the presence of GBS was collected three weeks post consent or when a participant was in labour. ResultsNo significant difference was found in vaginal GBS rates between the control and intervention groups. Only seven of 21 women in the intervention group completed the entire 21 days of probiotics. A subgroup analysis, including only those who had completed 14 days or more of probiotics (n=16), also showed no significant difference in vaginal GBS when compared to the control. As a secondary finding of the analysis did show significantly more vaginal commensals in the probiotics group (p=0.048).iii DiscussionThere are five possible reasons for the lack of significant results: The length of the intervention was too short. The dosage of the probiotics was too low. The wrong strains of probiotics were used. The sample size was inadequate. Oral probiotics are ineffective in impacting vaginal GBS. ImplicationsThe secondary finding of a significant increase of vaginal commensals (normal

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“…Probiotics, "live microorganisms which when administered in adequate amounts confer a health benefit on the host" (3), have been shown to promote and restore healthy vaginal microbiota in clinical trials (2)(3)(4). Both oral and intravaginal probiotic regimens for the prevention and treatment of bacterial vaginosis (BV) (5)(6)(7)(8) and urinary tract infections (UTIs) (9,10) have demonstrated clinical efficacy. Because probiotic lactobacilli express a number of characteristics that are antagonistic to pathogens but complementary to host immunity, their use has been proposed to improve reproductive health and pregnancy outcomes (11).…”

mentioning

confidence: 99%

“…The intravaginal administration of probiotics traditionally has been achieved using a variety of dosage forms, including tablets (21), capsules (7,8), suppositories (9), and tampons (22). Collectively, these approaches have led to detectable, but not optimally sustainable, levels of the delivered bacteria.…”

mentioning

confidence: 99%

Sustained Delivery of Commensal Bacteria from Pod-Intravaginal Rings

Gunawardana

Mullen

Yoo

et al. 2014

Antimicrob Agents Chemother

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Topical administration of live commensal bacteria to the vaginal tract holds significant potential as a cost-effective strategy for the treatment of sexually transmitted infections and the delivery of mucosal vaccines. Probiotic-releasing intravaginal rings (IVRs) embody significant theoretical advantages over traditional daily-dosage forms, such as sustained and controlled delivery leading to improved adherence to therapy compared to that of frequent dosing. The conventional IVR designs, however, are not amenable to the delivery of live bacteria. We have developed a novel pod-IVR technology where polymer-coated tablets ("pods") of Lactobacillus gasseri strain ATCC 33323, a commensal microorganism of human origin, are embedded in silicone IVRs. The release rate of bacterial cells is controlled by the diameter of a delivery channel that exposes a portion of the pod to external fluids. In vitro studies demonstrated that the prototype devices released between 1.1 ؋ 10 7 and 14 ؋ 10 7 cells per day for up to 21 days in a controlled sustained fashion with stable burst-free release kinetics. The daily release rates were correlated with the cross-sectional area of the delivery channel. Bacteria in the IVR pods remained viable throughout the in vitro studies and formed biofilms on the surfaces of the devices. This proof-of-principle study represents the first demonstration of a prolonged, sustained release of bacteria from an intravaginal device and warrants further investigation of this device as a nonchemotherapeutic agent for the restoration and maintenance of normal urogenital flora.

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

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

Cited by 61 publications

References 16 publications

Normal vaginal flora, disorders and application of probiotics in pregnancy

Normal vaginal flora, disorders and application of probiotics in pregnancy

The impact of oral probiotics on vaginal Group B Streptococcal colonisation rates in pregnant women: A pilot randomised control study

Sustained Delivery of Commensal Bacteria from Pod-Intravaginal Rings

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