Improved cure of bacterial vaginosis with single dose of tinidazole (2 g), Lactobacillus rhamnosus GR-1, and Lactobacillus reuteri RC-14: a randomized, double-blind, placebo-controlled trial
Abstract
Bacterial vaginosis (BV) is the most prevalent vaginal infection worldwide and is characterized by depletion of the indigenous lactobacilli. Antimicrobial therapy is often ineffective. We hypothesized that probiotic Lactobacillus rhamnosus GR-1 and Lactobacillus reuteri RC-14 might provide an adjunct to antimicrobial treatment and improve cure rates. Sixty-four Brazilian women diagnosed with BV were randomly assigned to receive a single dose of tinidazole (2 g) supplemented with either 2 placebo capsules or 2 capsules containing L. rhamnosus GR-1 and L. reuteri RC-14 every morning for the following 4 weeks. At the end of treatment (day 28), the probiotic group had a significantly higher cure rate of BV (87.5%) than the placebo group (50.0%) (p = 0.001). In addition, according to the Gram-stain Nugent score, more women were assessed with “normal” vaginal microbiota in the probiotic group (75.0% vs. 34.4% in the placebo group; p = 0.011). This study shows that probiotic lactobacilli can provide benefits to women being treated with antibiotics for an infectious condition.
Résumé
La vaginite bactérienne (VB) est l’infection vaginale la plus commune dans le monde et elle est caractérisée par une déplétion des lactobacilles indigènes. La thérapie antimicrobienne est souvent inefficace. Nous émettons l’hypothèse que les probiotiques Lactobacillus rhamnosus GR-1et Lactobacillus reuteri RC-14 puissent fournir un adjuvant au traitement antimicrobien et améliorer le taux de guérison. Soixante-quatre Brésiliennes souffrant de VB ont été choisies de façon aléatoire pour recevoir une seule dose de tinidazole (2 g) et 2 capsules de placebo ou 2 capsules contenant L. rhamnosus GR-1 et L. reuteri RC-14 à chaque matin pendant les 4 semaines suivantes. À la fin du traitement (28ième jour), le groupe avec probiotiques affichait un taux de guérison significativement plus élevé (87.5 %) comparativement au groupe placebo (50.0 %)(p = 0.0001). Aussi, selon le score de Nugent après coloration de Gram, plus de femmes ont été considérées porteuses d’une flore vaginale microbiotique normale dans le groupe avec probiotiques (75.0 % versus 34.4 % chez le groupe placebo; p = 0.011). Cette étude démontre que les lactobacilles probiotiques peuvent être bénéfiques aux femmes traitées avec des antibiotiques pour une condition infectieuse.
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Published In
Canadian Journal of Microbiology
Volume 55 • Number 2 • February 2009
Pages: 133 - 138
History
Received: 15 September 2008
Accepted: 3 October 2008
Version of record online: 2 March 2009
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Rafael C. R.MartinezR.C.R. Martinez, Sílvio A.FranceschiniS.A. Franceschini, Maristela C.PattaM.C. Patta, Silvana M.QuintanaS.M. Quintana, Bruna C.GomesB.C. Gomes, Elaine C. P.De MartinisE.C.P. DeMartinis, and GregorReidG. Reid. 2009. Improved cure of bacterial vaginosis with single dose of tinidazole (2 g), Lactobacillus rhamnosus GR-1, and Lactobacillus reuteri RC-14: a randomized, double-blind, placebo-controlled trial. Canadian Journal of Microbiology.
55(2): 133-138. https://doi.org/10.1139/W08-102
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