Probiotic Lactobacilli as a Novel Approach for Acute Candida Vulvovaginitis
In vitro studies suggest that certain probiotic bacterial strains may be effective against opportunistic infections such as Candida. There are few in vivo trials using probiotics as a single treatment for acute Candida vulvovaginitis (CV). In this open-label, proof-of-concept study, selected Lactobacillus strains were tested in women with acute Candida vaginitis.
Evaluating Probiotic Strains in a Clinical Setting
Twenty women diagnosed with confirmed, symptomatic CV were instructed to apply a vaginal probiotic gel containing L. plantarum YUN-V2.0, L. pentosus YUN-V1.0 and L. rhamnosus YUN-S1.0 for 10 consecutive days. Vaginal rinse fluid, a vaginal culture swab, and a vaginal smear for fresh wet-mount microscopy were collected before treatment and 7, 14, and 28 days after the start of treatment. On average, participating women were 39 years old and had a history of 5 vaginal infections, 95% of which were CV. Nine women (45%) completed the study without needing rescue medication. Women who required rescue treatment experienced twice as many Candida infections in the past. A negative correlation was found between the clinical composite score and the time to use rescue medication ( R2 = 0.127). Seventy-four percent of participants found the study gel comfortable to use, and 42% of all women would use the tested gel again for this indication. Forty-five percent of women were successfully treated for acute CV with a novel vaginal gel containing 3 selected Lactobacillus strains. Patients requiring rescue treatment were suffering from more severe and long-standing disease. These results warrant further testing of this new product, particularly to assess its potential in cases of mild to moderate severity, as an adjunct to antifungal medications or as a preventive measure in women with recurrent vulvovaginal candidiasis.
Authors: Gilbert Donders, Gert Bellen, Eline Oerlemans, Ingmar Claes, Kateryna Ruban, Tim Henkens, Filip Kiekens, and Sarah Lebeer
