Activity of a lactobacillus acidophilus-based douche for the treatment of bacterial vaginosis

Objectives: Bacterial vaginosis is characterized by alteration of the normal vaginal microflora, in which a mixed anaerobic bacterial flora becomes prevalent over the population of lacobacilli. Because administration of probiotics might be of some utility in restoring a normal flora, the present study aimed to evaluate the effect of a Lactobacillus acidophilus-strain-based douche on the vaginal environment in bacterial vaginosis. Patients and methods: In an open-label pilot evaluation, 40 women with bacterial vaginosis as defined by Amsel's criteria were treated for 6 days with a douche containing L. acidophilus. Vaginal smears were collected from the patients and analyzed according to Nugent's criteria at the time of diagnosis, after 6 days of treatment, and again at 20 days after the last treatment. At the same times, determination of vaginal pH and a Whiff test were performed. Results: The Nugent score decreased significantly from bacterial vaginosis or an intermediate flora toward a normal flora during treatment, and remained low during the follow-up period for almost all of the patients, indicating bacterial vaginosis in 52.5% and in 7.5% of the patients before treatment and at follow-up, respectively. After treatment, significant decreases in vaginal pH were observed, to less than pH 4.5 in 34/40 women, and the odor test became negative in all of the patients. Conclusions: In this preliminary study, treatment of bacterial vaginosis with a vaginal douche containing a strain of L. acidophilus contributed to the restoration of a normal vaginal environment.