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

  • Andrey SgibnevEmail author
  • Elena Kremleva
Original Article

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.

Keywords

Bacterial vaginosis Lactobacillus Metronidazole Probiotics Trichomonas vaginalis 

Notes

Acknowledgments

The authors wish to thank all gynecologists and volunteers who have participated in this study. The authors are sincerely grateful to Victoria Yansubaeva for her help in English language editing.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

The study was conducted according to Guidelines for Good Clinical Practice and was approved by the Human Research Ethics Committee at Orenburg State Medical University on March 10, 2017 (Orenburg, Russia, HRECOSMU-165/10/03/2017). Informed consent was provided prior to recruitment and participation.

Informed consent

Before inclusion in the study, the researcher provided the volunteer with all the information about the study. The volunteer gave written consent for the processing of her personal data implemented as part of this study and to an enabled research results analysis. When the volunteer gives her consent, she and the researcher signed and dated the consent form.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of the Study of the Mechanisms of Formation Microbial Biocenosis of HumansInstitute of Cellular and Intracellular SymbiosisOrenburgRussian Federation
  2. 2.Department of BiochemistryOrenburg State Medical UniversityOrenburgRussian Federation
  3. 3.Department of Obstetrics and GynecologyOrenburg State Medical UniversityOrenburgRussian Federation

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