Probiotics for prevention of recurrent vulvovaginal candidiasis: a review

Abstract

Vulvovaginal candidiasis (VVC) is a common infection affecting the quality of life of many women. Probiotics have been investigated as possible agents for the prevention of recurrences of VVC. We reviewed the available literature. In some studies the development of VVC was associated with either a low number of lactobacilli in the vagina or with the presence of H2O2-non-producing vaginal lactobacilli, although there are a few studies not supporting these statements. In addition, in vitro studies have shown that lactobacilli can inhibit the growth of Candida albicans and/or its adherence on the vaginal epithelium. The results of some clinical trials support the effectiveness of lactobacilli, especially Lactobacillus acidophilus, Lactobacillus rhamnosus GR-1 and Lactobacillus fermentum RC-14, administered either orally or intravaginally in colonizing the vagina and/or preventing the colonization and infection of the vagina by C. albicans, while the results of a small number of clinical trials do not corroborate these findings. Nevertheless, most of the relevant clinical trials had methodological problems such as small sample size, no control group (placebo) and included women without confirmed recurrent VVC, and thus they are not reliable for drawing definitive conclusions. Thus, the available evidence for the use of probiotics for prevention of recurrent VVC is limited. However, the empirical use of probiotics may be considered in women with frequent recurrence of VVC (more than three episodes per year), especially for those who have adverse effects from or contraindications for the use of antifungal agents, since adverse effects of probiotics are very rare. In any case women should be clearly informed about the unproven usefulness of probiotics for this purpose. In conclusion, despite the promising results of some studies, further research is needed to prove the effectiveness of probiotics in preventing the recurrences of VVC and to allow their wide use for this indication.

Biosurfactants and Bioemulsifiers Biomedical and Related Applications – Present Status and Future Potentials

“…Evidence suggests that probiotic organisms may have a role in lowering the incidence or the duration of antibiotic-related diarrhea, contributing to the prevention or treatment of vaginal candidiasis, bacterial vaginosis and recurrent lower urinary tract infections. Furthermore, they encourage improved immunological defense responses and can decrease the activity of numerous toxic antimetabolites (Falagas et al, 2006a(Falagas et al, , 2006b(Falagas et al, , 2007. Probiotics mechanisms of action vary, however, some are known to produce various antimicrobial agents such as organic acids, hydrogen peroxide, carbon peroxide, diacetyl, low molecular weight antimicrobial substances and bacteriocins (Merk et al, 2005).…”

Lactobacillus acidophilus ATCC 4356 inhibits biofilm formation by C. albicans and attenuates the experimental candidiasis in Galleria mellonella

“…All of these strains were able to inhibit the growth of C. albicans, but the inhibitory effects were dependent on the strain tested, dose administered and duration of treatment. [10][11][12] Therefore, further studies are needed to elucidate the inhibitory activity of Lactobacillus strains against C. albicans, particularly in terms of biofilm formation, filamentation capacity and infection potential.…”

Antifungal activity of lactic acid bacteria of Lactobacillus genus

“…Szczególnie oporne na działanie związków produkowanych przez bakterie mlekowe są droż-dże, w szczególności chorobotwórcze szczepy Candida sp. [17]. Niemniej niektóre szczepy bakterii mlekowych (L. acidophilus, L. rhamnosus GR-1 i L. fermentum RC-14) hamują wzrost drożdży Candida albicans oraz ograniczają ich adherencję do nabłonka pochwy [17].…”

“…[17]. Niemniej niektóre szczepy bakterii mlekowych (L. acidophilus, L. rhamnosus GR-1 i L. fermentum RC-14) hamują wzrost drożdży Candida albicans oraz ograniczają ich adherencję do nabłonka pochwy [17]. Zróżnicowanie aktywności przeciwgrzybowej bakterii z rodzaju Lactobacillus zaobserwowali Fhoula i wsp.…”