Lactobacilli‐containing vaginal probiotics to cure or prevent bacterial or fungal vaginal dysbiosis: a systematic review and recommendations for future trial designs

van de Wijgert, Janneke HHM ORCID: 0000-0003-2728-4560 and Verwijs, Marijn C (2019) Lactobacilli‐containing vaginal probiotics to cure or prevent bacterial or fungal vaginal dysbiosis: a systematic review and recommendations for future trial designs. BJOG : an international journal of obstetrics and gynaecology, 127 (2). pp. 287-299.

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Abstract

Background Vaginal probiotics claiming to cure and/or prevent bacterial and/or fungal vaginal dysbiosis are available on the market but, until recently, did not have to be approved as drugs for human use. Objectives We evaluated the impact of vaginal probiotics on bacterial vaginosis (BV ) and vulvovaginal candidiasis (VVC ) cure and/or recurrence, as well as vaginal microbiota (VMB ) composition and vaginal detection of probiotic strains. Search strategy We performed a systematic literature search in MEDLINE and Embase up to 15 January 2019. Selection criteria There were no restrictions in probiotic strains/formulations, study populations, and designs. BV had to be diagnosed by Nugent or Ison‐Hay Gram stain scoring, VVC by culture, wet mount or PCR , and VMB composition/detection by molecular techniques. Data collection and analysis The authors independently extracted data. Main results All 22 vaginal probiotics evaluated in the 34 eligible studies contained Lactobacillus strains, and some contained additional active ingredients. The probiotics hold promise for BV cure and prevention, but much less so for VVC cure and prevention. No major safety concerns were reported in any of the studies. Vaginal detection of probiotic strains never lasted long beyond the dosing period, suggesting that they did not colonise the vagina. However, findings are not definitive because heterogeneity was high and the quality of most studies suboptimal. Conclusions Availability of vaginal probiotics for vaginal health indications will likely decline in 2020 because of regulatory changes. We urge the field to invest in clinical evidence‐based product development and to conduct future trials more rigorously.

Item Type:	Article
Uncontrolled Keywords:	Bacterial vaginosis, lactobacilli, live biotherapeutic products, probiotics, vaginal microbiota, vulvovaginal candidiasis
Depositing User:	Symplectic Admin
Date Deposited:	31 Jul 2019 14:51
Last Modified:	18 Feb 2023 05:20
DOI:	10.1111/1471-0528.15870
Related URLs:	Author Publisher
URI:	https://livrepository.liverpool.ac.uk/id/eprint/3050696

Available Versions of this Item

• Lactobacilli-containing vaginal probiotics to cure or prevent bacterial or fungal vaginal dysbiosis: a systematic review and recommendations for future trial designs. (deposited 31 Jul 2019 13:31)
  • Lactobacilli‐containing vaginal probiotics to cure or prevent bacterial or fungal vaginal dysbiosis: a systematic review and recommendations for future trial designs. (deposited 31 Jul 2019 14:51) [Currently Displayed]