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VOLUME 14 , ISSUE 3 ( May-June, 2022 ) > List of Articles

REVIEW ARTICLE

Prebiotics and Probiotics in Vulvovaginal Infections

Ashwini B Gandhi, Ameya Purandare, Kavitha Athota, Priya G Kumar, Sudha Tandon, Shobhit Seth, Poonam Shah

Keywords : Bacterial vaginosis, Pregnancy, Probiotics, Synbiotics, Vulvovaginal infections

Citation Information : Gandhi AB, Purandare A, Athota K, Kumar PG, Tandon S, Seth S, Shah P. Prebiotics and Probiotics in Vulvovaginal Infections. J South Asian Feder Obs Gynae 2022; 14 (3):343-346.

DOI: 10.5005/jp-journals-10006-2053

License: CC BY-NC 4.0

Published Online: 27-07-2022

Copyright Statement:  Copyright © 2022; The Author(s).


Abstract

Aim: To discuss the role of prebiotics and probiotics in vulvovaginal infections. Background: Depletion of vaginal microflora in healthy women can lead to various vulvovaginal infections (VVIs). Probiotics such as Lactobacilli are used successfully in treatment and prevention of VVIs. Prebiotics are nutrient substrates for probiotics. Review results: Different strains of Lactobacilli possess different activities (pathogen displacement, bactericidal, and immunostimulatory) that are beneficial in women with VVIs. In nonpregnant women, probiotics administration either orally or vaginally improves clinical, mycological cure rate, and also reduces the recurrences in VVIs. In pregnant women also, probiotics are useful for bacterial vaginosis (BV). In pregnant women, it improves glucose metabolism and might be useful in cases with preterm premature rupture of membranes. Conclusion: In VVIs, intravaginal microbial environment is dysregulated. Upregulating this microflora environment with the use of pre- and probiotics, referred as synbiotics, increases treatment success rate and helps in prevention of recurrences. Clinical significance: Probiotic and prebiotic combination can be considered as one of the essential aspects in the management of VVIs.

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  1. Report of a joint FAO/WHO expert consultation on evaluation of health and nutritional properties of probiotics in food including powder milk and live lactic acid bacteria. Cordoba, Argentina: Food and Agriculture Organisation (FAO)/World Health organisation (WHO); 2001. Available from: http://www.fao.org/3/a-a0512e.pdf [Accessed January 27, 2018].
  2. Jarde A, Lewis-Mikhael AM, Moayyedi P, et al. Pregnancy outcomes in women taking probiotics or prebiotics: a systematic review and meta-analysis. BMC Pregnancy Childbirth 2018;18(1):14. DOI: 10.1186/s12884-017-1629-5.
  3. Ford AC, Quigley EM, Lacy BE, et al. Efficacy of prebiotics, probiotics, and synbiotics in irritable bowel syndrome and chronic idiopathic constipation: systematic review and meta-analysis. Am J Gastroenterol 2014;109(10):1547–1561. DOI: 10.1038/ajg.2014.202.
  4. Goldenberg JZ, Yap C, Lytvyn L, et al. Probiotics for the prevention of Clostridium difficile-associated diarrhea in adults and children. Cochrane Database Syst Rev 2017;12(12):CD006095. DOI: 10.1002/14651858.CD006095.pub4.
  5. Kirihara N, Kamitomo M, Tabira T, et al. Effect of probiotics on perinatal outcome in patients at high risk of preterm birth. J Obstet Gynaecol Res 2018;44(2):241–247. DOI: 10.1111/jog.13497.
  6. Reid G, Bocking A. The potential for probiotics to prevent bacterial vaginosis and preterm labor. Am J Obstet Gynecol 2003;189(4): 1202–1208. DOI: 10.1067/s0002-9378(03)00495-2.
  7. Xie HY, Feng D, Wei DM, et al. Probiotics for vulvovaginal candidiasis in non-pregnant women. Probiotics for vulvovaginal candidiasis in non-pregnant women. Cochrane Database Syst Rev 2017;11(11):CD010496. DOI: 10.1002/14651858.CD010496.pub2.
  8. Tan H, Fu Y, Yang C, et al. Effects of metronidazole combined probiotics over metronidazole alone for the treatment of bacterial vaginosis: a meta-analysis of randomized clinical trials. Arch Gynecol Obstet 2017;295:1331–1339. DOI: 10.1007/s00404-017-4366-0.
  9. Homayouni A, Bastani P, Ziyadi S, et al. Effects of probiotics on the recurrence of bacterial vaginosis: a review. J Low Genit Tract Dis 2014;18(1):79–86. DOI: 10.1097/LGT.0b013e31829156ec.
  10. Ford AC, Moayyedi P, Lacy BE, et al. American College of Gastroenterology monograph on the management of irritable bowel syndrome and chronic idiopathic constipation. Am J Gastroenterol 2014;109:S2–S26. DOI: 10.1038/ajg.2014.187.
  11. Rutten N, Van der Gugten A, Uiterwaal C, et al. Maternal use of probiotics during pregnancy and effects on their offspring's health in an unselected population. Eur J Pediatr 2016;175(2):229–235. DOI: 10.1007/s00431-015-2618-1.
  12. Turovskiy Y, Noll KS, Chikindas ML. The etiology of bacterial vaginosis. J Appl Microbiol 2011;110(5):1105–1128. DOI: 10.1111/j.1365-2672.2011.04977.x.
  13. Rampersaud R, Randis TM, Ratner AJ. Microbiota of the upper and lower genital tract. Semin Fetal Neonatal Med 2012;17(1):51–57. DOI: 10.1016/j.siny.2011.08.006.
  14. Zarbo G, Coco L, Leanza V, et al. Aerobic vaginitis during pregnancy. Res Obstet Gynecol 2013;2(2):7–11. DOI: 10.5923/j.rog.20130202.01.
  15. Srinivasan U, Misra D, Marazita ML, et al. Vaginal and oral microbes, host genotype and preterm birth. Med Hypotheses 2009;73(6): 963–975. DOI: 10.1016/j.mehy.2009.06.017.
  16. Donders GG, Vereecken A, Bosmans E, et al. Definition of a type of abnormal vaginal flora that is distinct from bacterial vaginosis: aerobic vaginitis. BJOG 2002;109(1):34–43. DOI: 10.1111/j.1471-0528.2002.00432.x.
  17. Sobel JD. Vulvovaginal candidosis. Lancet 2007;369(9577): 1961–1971. DOI: 10.1016/S0140-6736(07)60917-9.
  18. Weerasekera MM, Gunasekara TDCP, Fernando N, et al. Vulvovaginal candidiasis in patients presenting with vaginal discharge in a Sri Lankan setting. J South Asian Feder Obst Gynae 2016;8(2):123–126. DOI: 10.5005/jp-journals-10006-1400.
  19. Naik K, Avinash, Nusrat H, et al. An RCT for efficacy of oral probiotics in treatment of cases with symptomatic white discharge per vagina in rural population. J South Asian Feder Obst Gynae 2012;4(3):126–129. DOI: 10.5005/jp-journals-10006-1193.
  20. Mastromarino P, Vitali B, Mosca L. Bacterial vaginosis: a review on clinical trials with probiotics. New Microbiol 2013;36(3):229–238. PMID: 23912864.
  21. Gibson GR, Hutkins R, Sanders ME, et al. Expert consensus document: The International Scientific Association for Probiotics and Prebiotics (ISAPP) consensus statement on the definition and scope of prebiotics. Nat Rev Gastroenterol Hepatol 2017;14(8):491–502. DOI: 10.1038/nrgastro.2017.75.
  22. Gyawali R, Nwamaioha N, Fiagbor R, et al. The role of prebiotics in disease prevention and health promotion. In: Dietary interventions in gastrointestinal diseases. 1st ed. Academic Press; 2019. p. 151–167.
  23. Roberfroid M, Gibson GR, Hoyles L, et al. Prebiotic effects: metabolic and health benefits. Br J Nutr 2010;104:S1–S63. DOI: 10.1017/S0007114510003363.
  24. Collins SL, McMillan A, Seney S, et al. Promising prebiotic candidate established by evaluation of lactitol, lactulose, raffinose, and oligofructose for maintenance of a lactobacillus-dominated vaginal microbiota. Appl Environ Microbiol 2018;84(5):e02200–e02217. DOI: 10.1128/AEM.02200-17.
  25. Superti F, De Seta F. Warding off recurrent yeast and bacterial vaginal infections: lactoferrin and lactobacilli. Microorganisms 2020;8(1):130. DOI: 10.3390/microorganisms8010130.
  26. Bertuccini L, Russo R, Iosi F, et al. Effects of Lactobacillus rhamnosus and Lactobacillus acidophilus on bacterial vaginal pathogens. Int J Immunopathol Pharmacol 2017;30(2):163–167. DOI: 10.1177/0394632017697987.
  27. De Seta F, Parazzini F, De Leo R, et al. Lactobacillus plantarum P17630 for preventing Candida vaginitis recurrence: a retrospective comparative study. Eur J Obstet Gynecol Reprod Biol 2014;182: 136–139. DOI: 10.1016/j.ejogrb.2014.09.018.
  28. Oduyebo OO, Anorlu RI, Ogunsola FT. The effects of antimicrobial therapy on bacterial vaginosis in non-pregnant women. Cochrane Database Syst Rev 2009;3:CD006055. DOI: 10.1002/14651858.CD006055.pub2.
  29. Huang H, Song L, Zhao W. Effects of probiotics for the treatment of bacterial vaginosis in adult women: a meta-analysis of randomized clinical trials. Arch Gynecol Obstet 2014;289(6):1225–1234. DOI: 10.1007/s00404-013-3117-0.
  30. Sherrard J, Donders G, White D, et al. European (IUSTI/WHO) guideline on the management of vaginal discharge. Int J STD AIDS 2011;22(8):421–429. DOI: 10.1258/ijsa.2011.011012.
  31. Royal College of Obstetricians & Gynaecologists; British Association for Sexual Health and HIV. The management of women of reproductive age attending non-genitourinary medicine settings complaining of vaginal discharge. J Fam Plann Reprod Health Care 2006;32(1):33–42. DOI: 10.1783/147118906775275172.
  32. Mendling W, Brasch J, Cornely OA, et al. Guideline: vulvovaginal candidosis (AWMF 015/072), S2k (excluding chronic mucocutaneous candidosis). Mycoses 2015;58 Suppl 1:1–15. DOI: 10.1111/myc.12292.
  33. Van Schalkwyk J, Yudin MH, Allen V, et al. Vulvovaginitis: screening for and management of trichomoniasis, vulvovaginal candidiasis, and bacterial vaginosis. J Obstet Gynaecol Can 2015;37(3):266–274. DOI: 10.1016/S1701-2163(15)30316-9.
  34. Centers for Disease Control and Prevention. Sexually transmitted diseases treatment guidelines, 2015. MMWR Recomm Rep 2015;64(RR-03):1–137. PMID: 26042815.
  35. Buggio L, Somigliana E, Borghi A, et al. Probiotics and vaginal microecology: fact or fancy? BMC Women's Health 2019;19(1):25. DOI: 10.1186/s12905-019-0723-4.
  36. Daskalakis GJ, Karambelas AK. Vaginal probiotic administration in the management of preterm premature rupture of membranes. Fetal Diagn Ther 2017;42(2):92–98. DOI: 10.1159/000450995.
  37. Neri A, Sabah G, Samra Z. Bacterial vaginosis in pregnancy treated with yoghurt. Acta Obstet Gynecol Scand 1993;72(1):17–19. DOI: 10.3109/00016349309013342.
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