Preventive Nutrition and Food Science

The Korean Society of Food Science and Nutrition (한국식품영양과학회)
권호 표지
DOI QR코드

DOI QR Code

Effect of Lactobacilli Oral Supplement on the Vaginal Microflora of Antibiotic Treated Patients: Randomized, Placebo-Controlled Study

  • Reid,Gregor (Canadian Research and Development Centre for Probiotics, Lawson Health Research Institute) ;
  • Hammond, Jo-Anne (Canadian Research and Development Centre for Probiotics, Lawson Health Research Institute) ;
  • Bruce, Andrew W. (Canadian Research and Development Centre for Probiotics, Lawson Health Research Institute)
  • Published : 2003.06.01
Download PDF
⟨ Previous Next ⟩

Abstract

Many antibiotic monographs cite the induction of vaginal infections as a possible side effect. Invariably, this is believed to be due to Candide albicans, and empirical therapy is given. However, recent studies raise the question of the extent to which yeast do infect the host after antibiotic use. A double-blind, randomized, placebo-controlled study was undertaken on female patients to determine how many yeast infections occurred following 10 days antibiotic use. In addition, the study was designed to examine whether oval use of probiotic lactobacilli can reduce the risk of vaginal infection. Twenty four patients diagnosed with respiratory, oval or throat infections received one of several types of antibiotic for 10 days, and two capsules containing 10$^{9}$ dried Lactobacillus rhamnosus GR-1 and L. fermentum RC-14 from the day of commencement of antibiotic therapy for 21 days. The most commonly prescribed antibiotic was biaxin (clarithromycin). All but one patient had lactobacilli in the vagina upon entry to the study, and none developed yeast vaginitis or diarrhea during treatment or 20 days after completion of antibiotics. The mean Nugent score was higher in the placebo than the lactobacilli group (4.1 versus 2.4), and three cases of bacterial vaginosis arose (25 % incidence compared to 0% in the lactobacilli group) in the placebo group (2 receiving cefuroxime, 1 on biaxin). The study suggested that current antibiotic use is not necessarily associated with either diarrhea or yeast infection, as is often surmised. Nevertheless, daily use of probiotics was safe and could potentially reduce the risk of patients developing bacterial vaginosis after antibiotic use.

Keywords

References

  1. Abbott J. 1995. Clinical and microscopic diagnosis of vaginal yeast infection: a prospective analysis. Ann Emerg Med 25: 587-591 https://doi.org/10.1016/S0196-0644(95)70168-0
  2. Daus AD, Hafez ES. 1975. Candida albicans in women.Nurs Res 24: 430-433 https://doi.org/10.1097/00006199-197511000-00005
  3. Ferris DG, Litaker MS, Woodward L, Mathis D, Hendrich J. 1995. Treatment of bacterial vaginosis: a comparison of oral metronidazole, metronidazole vaginal gel, and clindamycin vaginal cream. . J Fam Pract 41: 443-449
  4. Glover DD, Larsen B. 1998. Longitudinal investigation of candida vaginitis in pregnancy: role of superimposed antibiotic use. Obstet Gynecol 91: 115-118 https://doi.org/10.1016/S0029-7844(97)00588-7
  5. Reid G, Bruce AW, Cook RL, Llano M. 1990. Effect on the urogenital flora of antibiotic therapy for urinary tract infection. Scand J Infect Dis 22: 43-47 https://doi.org/10.3109/00365549009023118
  6. Reid G, Bruce AW, Taylor M. 1995. Instillation of Lactobacillus and stimulation of indigenous organisms to prevent recurrence of urinary tract infections. Microecol Ther 23: 32-45
  7. Reid G, Beuerman D, Heinemann C, Bruce AW. 2001.Probiotic Lactobacillus dose required to restore and maintain a normal vaginal flora. FEMS Immunol Med Microbiol 32: 37-41 https://doi.org/10.1111/j.1574-695X.2001.tb00531.x
  8. Reid G, Charbonneau D, Erb J, Kochanowski B, Beuerman D, Poehner R, Bruce AW. 2003. Oral use of Lactobacillus rhamnosus GR-1 and L.fermentum RC-14 significantly alters vaginal flora: randomized, placebo-controlled trial in 64 healthy women. FEMS Immunol Med Microbiol 35: 131-134 https://doi.org/10.1016/S0928-8244(02)00465-0
  9. Cadieux P, Burton J, Gardiner G, Braunstein I, Bruce AW, Kang CY, Reid G. 2002. Lactobacillus strains and vaginal ecology. JAMA 287: 1940-1941 https://doi.org/10.1001/jama.287.15.1940
  10. Nugent RP, Krohn MA, Hillier SL. 1991. Reliability of diagnosing bacterial vaginosis is improved by a standardization method of Gram stain interpretation. .J Clin Microbiol 29: 297-301
  11. Agnew KJ, Hillier SL. 1995. The effect of treatment regimens for vaginitis and cervicitis on vaginal colonization by lactobacilli. Sex Transm Dis 22: 269-273 https://doi.org/10.1097/00007435-199509000-00001
  12. Cauci S, Driussi S, De Santo D, Penacchioni P, Iannicelli T, Lanzafame P, De Seta F, Quadrifoglio F, de Aloysio D, Guaschino S. 2002. Prevalence of bacterial vaginosis and vaginal flora changes in peri- and postmenopausal women. J Clin Microbiol 40: 2147-2152 https://doi.org/10.1128/JCM.40.6.2147-2152.2002
  13. Geerlings SE, Stolk RP, Camps MJ, Netten PM, Collet TJ, Hoepelman AI. 2000. Diabetes Women Asymptomatic Bacteriuria Utrecht Study Group. Risk factors for symptomatic urinary tract infection in women with diabetes. Diabetes Care 23: 1737-1741 https://doi.org/10.2337/diacare.23.12.1737
  14. Hillebrand L, Harmanli OH, Whiteman V, Khandelwal M.2002. Urinary tract infections in pregnant women with bacterial vaginosis. Am J Obstet Gynecol 186: 916-917 https://doi.org/10.1067/mob.2002.123987
  15. Burton JP, Cadieux P, Reid G. 2003. Improved understanding of the bacterial vaginal microbiota of women before and after probiotic instillation. Appl Environ Microbiol 69: 97-101 https://doi.org/10.1128/AEM.69.1.97-101.2003
  16. Foxman B, Barlow R, D'Arcy H. 2000. Candida vaginitis: self-reported incidence and associated costs. Sex Trans Dis 27: 230-225 https://doi.org/10.1097/00007435-200004000-00009
  17. Sobel JD. 1997. Vaginitis. N Engl J Med 337: 1896-1903 https://doi.org/10.1056/NEJM199712253372607
  18. Lamont RF, Morgan DJ, Wilden SD, Taylor-Robinson D. 2000. Prevalence of bacterial vaginosis in women attending one of three general practices for routine cervical cytology. Int J STD AIDS 11: 495-498 https://doi.org/10.1258/0956462001916371
  19. Ferris DG, Nyirjesy P, Sobel JD, Soper D, Pavletic A, Litaker MS. 2002. Over-the-counter antifungal drug misuse associated with patient-diagnosed vulvovaginal candidiasis. Obstet Gynecol 99: 419-425 https://doi.org/10.1016/S0029-7844(01)01759-8
  20. Donder GG, Vereecken A, Bosmans E, Dekeersmaecker A, Salembier G, Spitz B. 2002. Definition of a type of abnormal vaginal flora that is distinct from bacterial vaginosis: aerobic vaginitis. BJOG 109: 34-43 https://doi.org/10.1111/j.1471-0528.2002.00432.x
  21. FAO/WHO. 2001. Evaluation of health and nutritional properties of powder milk and live lactic acid bacteria. Food and Agriculture Organization of the United Nations and World Health Organization Expert Consultation Report. http://www.fao.org/es/ESN/Probio/probio.htm
  22. Shalev E, Battino S, Weiner E, Colodner R, Keness Y. 1996. Ingestion of yogurt containing Lactobacillus acidophilus compared with pasteurized yogurt as prophylaxis for recurrent candidal vaginitis and bacterial vaginosis. Arch Fam Med 5: 593-596 https://doi.org/10.1001/archfami.5.10.593
  23. Hilton E, Isenberg HD, Alperstein P, France K, Borenstein MT. 1992. Ingestion of yogurt containing Lactobacillus acidophilus as prophylaxis for candidal vaginitis. Ann Intern Med 116: 353-357 https://doi.org/10.7326/0003-4819-116-5-353
  24. Kontiokari T, Laitinen J, Jarvi L, Pokka T, Sundqvist K, Uhari M. 2003. Dietary factors protecting women from urinary tract infection. Am J Clin Nutr 77: 600-604
  25. Spandorfer SD, Neuer A, Giraldo PC, Rosenwaks Z, Witkin SS. 2001. Relationship of abnormal vaginal flora, proinflammatory cytokines and idiopathic infertility in women undergoing IVF. J Reprod Med 46: 806-810
  26. Sewankambo N, Gray RH, Wawer MJ. 1997. HIV-1 infection associated with abnormal vaginal flora morphology and bacterial vaginosis. Lancet 350: 546-550 https://doi.org/10.1016/S0140-6736(97)01063-5

Cited by

  1. Probiotics prophylaxis in children with persistent primary vesicoureteral reflux vol.22, pp.9, 2007, https://doi.org/10.1007/s00467-007-0507-1
  2. Probiotics to prevent urinary tract infections: the rationale and evidence vol.24, pp.1, 2006, https://doi.org/10.1007/s00345-005-0043-1
  3. Scientific Opinion on the substantiation of health claims related to Lactobacillus rhamnosus GR-1 (ATCC 55826) in combination with Lactobacillus reuteri RC-14 (ATCC 55845) and defence against vaginal pathogens by increasing the proportion of lactobacilli vol.9, pp.6, 2011, https://doi.org/10.2903/j.efsa.2011.2232
  4. Probiotics in obstetrics and gynecology. Literature review vol.54, pp.None, 2003, https://doi.org/10.18370/2309-4117.2020.54.110-117