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Treating vaginitis with probiotics in nonpregnant females: A systematic review and metaanalysis

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Vaginitis, also known as vulvovaginitis, is an inflammation of the vagina and vulva and a common disease in females. It is thought to be caused by vaginal dysbiosis and improved by probiotics. Bacterial vaginosis (BV) and vulvovaginal candidiasis (VVC) are the major types of vaginal infections. The present systematic review and metaanalysis aimed to clarify the efficacy of probiotics in the treatment of common vaginal infections in nonpregnant females. Literature on randomized controlled trials and twoarmed prospective studies on any intervention with probiotics published until December 24th, 2018 was searched in the PubMed, Cochrane and EMBASE databases. The outcomes of interest were recurrence rate, cure rate, remission rate and normal vaginal flora restoration. Finally, a total of 30 studies on bacterial vaginosis (BV) and/or VVC were included and stratified into 3 study types based on treatment design as follows: Type I, antibiotic/probiotics vs. antibiotics/antifungals (22 studies); Type II, probiotics vs. placebo (5 studies); Type III, probiotics vs. antibiotics (3 studies). The type I studies comprised 1,788 nonpregnant females and had the highest interstudy comparability in posttreatment followup design and metaanalysis outcome data. Probiotics interventions were significantly associated with a lower recurrence rate of vaginitis [pooled odds ratio (OR)=0.27, 95% CI: 0.180.41, P<0.001] and higher cure/remission rate (pooled OR=2.28, 95% CI: 1.204.32, P=0.011). However, a significant increase in normal vaginal flora after probiotic treatment was observed only in BV (pooled OR=4.55, 95% CI: 1.4414.35, P=0.01). In addition, supportive but heterogeneous results were obtained from the 6month followup data of TypeI studies, different infection types and supplementary analysis of TypeII studies. In conclusion, probiotics have a significant shortterm effect in the treatment of common vaginal infections in nonpregnant females. In order to evaluate the longterm effects of probiotics in common vaginal infections, it is worthwhile to perform higherquality clinical trials in the future.
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Document Type: Research Article

Affiliations: 1: Department of Chemical Engineering and Biotechnology, Institute of Chemical Engineering and Biotechnology, Tatung University, Taipei 10452, Taiwan, R.O.C. 2: School of Medicine for International Students, College of Medicine, IShou University, Kaohsiung 82445, Taiwan, R.O.C.

Publication date: October 1, 2020

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  • Experimental and Therapeutic Medicine aims to ensure the expedient publication, in both print and electronic format, of studies relating to biology, gene therapy, infectious disease, microbiology, molecular cardiology and molecular surgery. The journal welcomes studies pertaining to all aspects of molecular medicine, and studies relating to in vitro or in vivo experimental model systems relevant to the mechanisms of disease are also included.

    All materials submitted to this journal undergo the appropriate review via referees who are experts in this field. All materials submitted follow international guidelines with regard to approval of experiments on humans and animals.
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