Bacterial vaginosis and the role of prebiotics and probiotics: current practices

Mukesh Gupta; Brajbala Tiwari

doi:10.18203/2320-6012.ijrms20240866

Authors

Mukesh Gupta Le'Nest, Malad, Mumbai, Maharashtra, India
Brajbala Tiwari Lifecare Hospital, Indore, Madhya Pradesh, India

DOI:

https://doi.org/10.18203/2320-6012.ijrms20240866

Keywords:

Bacterial vaginosis, Prebiotic-probiotic supplementation, Dysbiosis, Bacteriocins

Abstract

Bacterial vaginosis (BV) is characterized by overgrowth of opportunistic bacteria and a decrease in the levels of Lactobacilli. BV is commonly encountered by gynaecologists practicing in India. The opinions of 21 gynaecologists across India regarding diagnosis and management of BV were sought via focussed group discussions. In Indian women, BV is more common in the reproductive age group, perimenopausal women, women with polycystic ovarian disease (PCOD), pregnant women, and in teenagers/pubertal age group. BV is often underestimated as it is not diagnosed by family physicians. The panel of experts opined that they preferred to conduct screening for BV in all high-risk pregnant cases, women with bad obstetric history such as premature abortions and women with a history of tuberculosis. One challenge faced by clinicians in the real-world setting is recurrent infections of BV in their patients. For the treatment of BV, antibiotics can be prescribed along with pre-probiotics to avoid dysbiosis and to prevent recurrence of BV. Pre-probiotics should be administered in sufficient amounts for adequate management of BV. More than 80% of Lactobacilli species should be present in an ideal pre-probiotic to ensure adequate production of acid and bacteriocins for the destruction of unhealthy bacteria and prevention of microfilm formation. The results with the pre-probiotics used will depend on the quality of the formulation and the maintenance of the cold chain. Prebiotic -probiotic supplementation may be considered a new adjuvant treatment for BV.

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References

Challa A, Kachhawa G, Sood S, Upadhyay AD, Dwivedi SN, Gupta S. Correlates of bacterial vaginosis among women from North India. Int J STD AIDS. 2022;33(7):666-71.

Coudray MS, Madhivanan P. Bacterial vaginosis-A brief synopsis of the literature. Eur J Obstet Gynecol Reprod Biol. 2020;245:143-8.

Bautista CT, Wurapa E, Sateren WB, Morris S, Hollingsworth B, Sanchez JL. Bacterial vaginosis: a synthesis of the literature on etiology, prevalence, risk factors, and relationship with chlamydia and gonorrhea infections. Mil Med Res. 2016;3:4.

Myer L, Denny L, Telerant R, Souza M, Wright TC Jr., Kuhn L Bacterial vaginosis and susceptibility to HIV infection in South African women: a nested case-control study. J Infect Dis. 2005;192(8):1372-80.

Kenyon C, Colebunders R, Crucitti T. The global epidemiology of bacterial vaginosis: a systematic review. Am J Obstet Gynecol. 2013;209(6):505-23.

Eriksson K, Adolfsson A, Forsum U, Larsson PG. The prevalence of BV in the population on the Aland Islands during a 15-year period. APMIS. 2010;118(11):903-8.

Gibbs RS. Asymptomatic bacterial vaginosis: is it time to treat? Am J Obstet Gynecol. 2007;196(6):495-6.

Redelinghuys MJ, Geldenhuys J, Jung H, Kock MM. Bacterial Vaginosis: Current Diagnostic Avenues and Future Opportunities. Front Cell Infect Microbiol. 2020;10:354.

Bhavana AM, Kumari PHP, Mohan N, Chandrasekhar V, Vijayalakshmi P, Manasa RV. Bacterial vaginosis and antibacterial susceptibility pattern of asymptomatic urinary tract infection in pregnant women at a tertiary care hospital, Visakhaptn, India. Iran J Microbiol. 2019;11(6):488-95.

Brotman RM, Klebanoff MA, Nansel TR, Yu KF, Andrews WW, Zhang J, et al. Bacterial vaginosis assessed by gram stain and diminished colonization resistance to incident gonococcal, chlamydial, and trichomonal genital infection. J Infect Dis. 2010;202(12):1907-15.

Chen X, Lu Y, Chen T, Li R. The Female Vaginal Microbiome in Health and Bacterial Vaginosis. Front Cell Infect Microbiol. 2021;11:631972.

Coleman JS, Gaydos CA. Molecular Diagnosis of Bacterial Vaginosis: an Update. J Clin Microbiol. 2018;56(9):e00342-18.

Salah RM, Allam AM, Magdy AM, Mohamed ASh. Bacterial vaginosis and infertility: cause or association? Eur J Obstet Gynecol Reprod Biol. 2013;167(1):59-63.

Mala R, Sood S, Kapil A, Gupta S, Singh N. Comparison of Amsel's criteria with low and high Nugent's scores for the diagnosis of bacterial vaginosis. Indian J Sex Transm Dis AIDS. 2022;43(1):56-8.

Modak T, Arora P, Agnes C, Ray R, Goswami S, Ghosh P, et al. Diagnosis of bacterial vaginosis in cases of abnormal vaginal discharge: comparison of clinical and microbiological criteria. J Infect Dev Ctries. 2011;5(5):353-60.

Romero Herrero D, Andreu Domingo A. Vaginosis bacteriana [Bacterial vaginosis]. Enferm Infecc Microbiol Clin. 2016;34(3):14-8.

Reiter S, Kellogg Spadt S. Bacterial vaginosis: a primer for clinicians. Postgrad Med. 2019;131(1):8-18.

Jean-Pierre Menard, Antibacterial treatment of bacterial vaginosis: current and emerging therapies. Int J Womens Health. 2011;3:295-305.

Bagnall P, Rizzolo D. Bacterial vaginosis: A practical review. JAAPA. 2017;30(12):15-21.

Hemalatha R, Mastromarino P, Ramalaxmi BA, Balakrishna NV, Sesikeran B. Effectiveness of vaginal tablets containing lactobacilli versus pH tablets on vaginal health and inflammatory cytokines: a randomized, double-blind study. Eur J Clin Microbiol Infect Dis. 2012;31(11):3097-105.

Yasodhara P, Raghunath M, Sreeramulu D, Venu L, Hemalatha R, Krishna TP. Local immunity in Indian women with bacterial vaginosis. J Reprod Immunol. 2006;70(1-2):133-41.

Heczko PB, Tomusiak A, Adamski P, Jakimiuk AJ, Stefański G, Mikołajczyk-Cichońska A, et al. Supplementation of standard antibiotic therapy with oral probiotics for bacterial vaginosis and aerobic vaginitis: a randomised, double-blind, placebo-controlled trial. BMC Womens Health. 2015;15:115.

Russo C, Caponnetto P, Cibella F, Maglia M, Alamo A, Campagna D, et al. A double blind randomized controlled trial investigating efficacy and safety of varenicline for smoking cessation in patients with type 2 diabetes: study protocol. Intern Emerg Med. 2021;16(7):1823-39.

Jeng H-S, Yan T-R, Chen J-Y. Treating vaginitis with probiotics in non-pregnant females: A systematic review and meta-analysis. Exp Ther Med. 2020;20(4):3749-65.

Li C, Wang T, Li Y, Zhang T, Wang Q, He J, et al. Probiotics for the treatment of women with bacterial vaginosis: A systematic review and meta-analysis of randomized clinical trials. Eur J Pharmacol. 2019;864:172660.

Liu HF, Yi N. A systematic review and meta-analysis on the efficacy of probiotics for bacterial vaginosis. Eur Rev Med Pharmacol Sci. 2022;26(1):90-8.

Chen R, Li R, Qing W, Zhang Y, Zhou Z, Hou Y, et al. Probiotics are a good choice for the treatment of bacterial vaginosis: a meta-analysis of randomized controlled trial. Reprod Health. 2022;19(1):137.

López-Moreno A, Aguilera M. Vaginal Probiotics for Reproductive Health and Related Dysbiosis: Systematic Review and Meta-Analysis. J Clin Med. 2021;10(7):1461.