Abstract
Background
Recurrence is a frequent complaint of patients with vulvovaginal candidiasis (VVC).
Although the pathogenesis of VVC remains a controversial issue, disruption of the
balance between the vaginal microbiota may facilitate overgrowth by Candida. Some
probiotic bacterial strains can suppress Candida albicans; Lactobacillus plantarum P17630 is able to attach to vaginal epithelial cells and significantly reduce the
adhesion of C. albicans.
Objective
To evaluate the effect of the application of Lactobacillus plantarum P17630 in restoring the vaginal microbiota and prevention of relapses among women
with acute VVC undergoing conventional (azole) local and main therapy.
Methods
Retrospective comparative study. We recruited 89 women with a diagnosis of VVC, who
were placed into two groups on the basis of reported treatment. The control group
was treated with a daily dose of 2% clotrimazole vaginal cream at bedtime for 3 days,
followed by vaginal application of a capsule containing lubricant once a day for 6
days and then once a week for another 4 weeks. The probiotic group was treated with
the same azole-based protocol but followed by vaginal application of a capsule containing
Lactobacillus plantarum P17630 (>108 CFU) once a day for 6 days and then once a week for another 4 weeks beginning the
day following clotrimazole discontinuation. Clinical and diagnostic patterns were
monitored for three months of follow-up.
Results
At the end of study the probiotic-treated women showed a statistically significant
increase in Lactobacillus values “+++” (80% versus 40%, p < 0.001) and a better subjective resolution of symptoms such as vaginal discomfort described
as burning or itching (90% versus 67.5%, p < 0.03). Among controls there was a non-significant increase at 3 months of recurrence
of infection, but a significant increase of women with value of pH = 5 or >5.
Conclusion
Although the results of different studies are controversial, most have suggested use
of probiotics in the prevention or treatment of VVC, and no adverse effects have been
reported. Our data with L. plantarum P17630 (Gyno-Canesflor - Bayer) confirm the role of this specific strain as a potential
empirical preventive agent for reducing vaginal discomfort after conventional treatment
of acute VVC and shifting the vaginal milieu toward a predominance of lactobacilli
with an improvement of the vaginal pH value.
Keywords
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Article info
Publication history
Published online: September 17, 2014
Accepted:
September 3,
2014
Received in revised form:
August 17,
2014
Received:
July 9,
2014
Identification
Copyright
© 2014 Elsevier Ireland Ltd. Published by Elsevier Inc. All rights reserved.
