Probiotics in addition to metronidazole for treatment Trichomonas vaginalis in the presence of BV: a randomized, placebo-controlled, double-blind study.

Andrey Sgibnev, Elena Kremleva

Journal: European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology 2020;39(2):345-351

PMID: 31705339

Abstract

The purpose was to evaluate whether probiotics can increase the effectiveness of antimicrobial therapy. Ninety women with Trichomonas vaginalis (TV) in the presence BV were included in the study of regimens for therapy combination with metronidazole and vaginal probiotics. For 7 days, the probiotics group patients received metronidazole at 500 mg twice a day and 1 capsule of probiotic Gynophilus® vaginally twice a day; the placebo group patients in addition to metronidazole received a placebo instead of a probiotic. For the next 7 days, patients in both groups in order restore normal microflora were given the probiotics vaginally. Before the treatment, on the 4th, 8th, and 15th day of therapy complaints, pH and redox potential of the vaginal fluid were recorded, TV detection culturally, microflora of the vagina with the qPCR-RT and microscopically. Adding probiotics to traditional therapy of TV in the presence of BV increased the likelihood of cure from TV (88.6 and 42.9% in the probiotic and placebo groups, respectively) and from BV (63.6 and 11.9%, respectively). We have found that the addition of probiotics to antimicrobial therapy causes the decrease in the inflammatory response and significant changes in the vagina's physicochemical parameters (decreased of the pH values, increased of the redox potential) already on the fourth day of the therapy. The changes in the metronidazole's antimicrobial action implementation when a probiotic is added are the reason of increasing the TV therapy's effectiveness in the BV presence.

Address: Department of the Study of the Mechanisms of Formation Microbial Biocenosis of Humans, Institute of Cellular and Intracellular Symbiosis, Pionerskaya Street, b. 11, of.107, Orenburg, Russian Federation, 460000. [email protected].; Department of Biochemistry, Orenburg State Medical University, Sovetskaya Street, b. 6, Orenburg, Russian Federation, 460000. [email protected].; Department of the Study of the Mechanisms of Formation Microbial Biocenosis of Humans, Institute of Cellular and Intracellular Symbiosis, Pionerskaya Street, b. 11, of.107, Orenburg, Russian Federation, 460000.; Department of Obstetrics and Gynecology, Orenburg State Medical University, Sovetskaya Street, b. 6, Orenburg, Russian Federation, 460000.

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