Treatment of Bacterial Vaginosis with an Acid Cream: A Comparison between the Effect of Lactate-Gel and Metronidazole

Andersch, Björn; Forssman, Lars; Lincoln, K.; Torstensson, Per

doi:10.1159/000298923

Cited by 57 publications

(42 citation statements)

References 4 publications

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“…5-4 . 6) were comparable to those determined in the healthy vagina (Andersch et al, 1986;Tevi-Bénissan et al, 1997). Boskey et al (1999) reported that eight vaginal Lactobacillus strains acidified the growth medium to an asymptotic pH of 3 .…”

Section: Discussionsupporting

confidence: 85%

Growth and lactic acid production by vaginal Lactobacillus acidophilus CRL 1259, and inhibition of uropathogenic Escherichia coli

Tomás

Ocaña

Wiese

et al. 2003

Journal of Medical Microbiology

108

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Lactic acid-producing lactobacilli were selected from 134 human vaginal isolates by testing their capability to inhibit the growth of different pathogenic micro-organisms. Lactobacillus acidophilus CRL 1259 (from the CERELA Culture Collection) was selected to study the effects of temperature, pH and culture medium on growth and lactic acid production. Growth parameters were estimated by using the model of Gompertz. Kinetics of inhibition of uropathogenic Escherichia coli were evaluated in mixed cultures of the pathogen and L. acidophilus. Optimal conditions for growth and lactic acid production by L. acidophilus were pH 6 . 5 or 8 . 0 and 37 8C. Under these conditions, growth was higher in LAPTg (yeast extract/peptone/tryptone/Tween 80/glucose) broth than in MRS (De ManRogosa-Sharpe) broth. However, lactic acid production was more efficient in MRS broth. Under optimal conditions for lactic acid production, L. acidophilus inhibited the growth of E. coli. These results suggest that inclusion of L. acidophilus CRL 1259 in probiotic products for vaginal application would be beneficial.

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Section: Discussionsupporting

confidence: 85%

Growth and lactic acid production by vaginal Lactobacillus acidophilus CRL 1259, and inhibition of uropathogenic Escherichia coli

Tomás

Ocaña

Wiese

et al. 2003

Journal of Medical Microbiology

108

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“…Acidification of the vagina has been tried by local application of products containing lactobacilli [4], lactic acid [5], hydrogen peroxide [6] and acetic acid [7]. A modern approach to decrease the pH, and consequently to get a long-lasting normalization of the vaginal flora, consists in the vaginal application of vitamin C (250 mg L-ascorbic acid) in the form of silicon-coated vitamin C tablets [8][9][10].…”

Section: Introductionmentioning

confidence: 99%

Vaginal pH-lowering effect of locally applied vitamin C in subjects with high vaginal pH

Polatti

Rampino

Magnani

et al. 2006

Gynecological Endocrinology

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The primary objective of this randomized, double-blind, controlled study was the assessment of the pH-lowering effect of three different formulations of a vaginal device each containing 250 mg vitamin C. Overall, 39 women with vaginal pH >or=5, without evidence of vaginal infections, were randomly assigned to receive one of the three formulations for 6 days. The primary parameter assessed was vaginal pH, performed by the physician at the baseline and final visits and by the subjects each day during the application period; secondary parameters included the acceptability and safety profile of the tested devices. A decrease in pH to the normal range in all groups was observed following the first application, with stable low values during the whole study period. No statistically significant differences were seen among the three groups, while statistically significant within-group differences were observed. Acceptability and tolerability were rated as very good/good in most cases. The study results confirm that the vaginal application of vitamin C has an effective and long-lasting vaginal pH-lowering effect.

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“…Anaerobes grow poorly at pH 4.5 or below [4]. The acid environment is maintained by the lactobacilli flora producing lactic acid [2], It has been shown that an acid gel is as effective as metronidazole for a short-term in BV [7]. Fifty percent of women treated with metronidazole relapsed after 2 months [8].…”

Section: Introductionmentioning

confidence: 99%

Bacterial Vaginosis and the Effect of Intermittent Prophylactic Treatment with an Acid Lactate Gel

Andersch¹,

Lindell²,

Dahlén

et al. 1990

Gynecol Obstet Invest

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Intermittent treatment with an acid lactate gel (Lactal, ACO, Sweden) reduced symptoms of bacterial vaginosis (BV) and promoted the reestablishment of the normal vaginal flora of lactobacilli. Forty-two women seriously affected by recurrent BV were initially given acid gel (lactate gel, pH 3.8, 5 ml) to be inserted into the vagina daily for 7 consecutive days. Thereafter they entered into a double blind clinical trial and were treated prophylactically 3 days monthly for 6 months with either lactate gel or a placebo gel. Women treated with the lactate gel were clinically improved, i.e. no signs of BV in 88% compared to 10% in the placebo group (p < 0.001). The vaginal lactobacilli flora was reestablished in 83% of the lactate group and in 16% of the placebo group. Local intermittent application of lactate gel was found to be free of side effects and is a preferable alternative to repeated treatments with antibiotics in patients with recurrent BV.

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Treatment of Bacterial Vaginosis with an Acid Cream: A Comparison between the Effect of Lactate-Gel and Metronidazole

Cited by 57 publications

References 4 publications

Growth and lactic acid production by vaginal Lactobacillus acidophilus CRL 1259, and inhibition of uropathogenic Escherichia coli

Growth and lactic acid production by vaginal Lactobacillus acidophilus CRL 1259, and inhibition of uropathogenic Escherichia coli

Vaginal pH-lowering effect of locally applied vitamin C in subjects with high vaginal pH

Bacterial Vaginosis and the Effect of Intermittent Prophylactic Treatment with an Acid Lactate Gel

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