Improved cure of bacterial vaginosis with single dose of tinidazole (2 g), Lactobacillus rhamnosus GR-1, and Lactobacillus reuteri RC-14: a randomized, double-blind, placebo-controlled trial

• Published in: Canadian journal of microbiology Vol. 55; no. 2; pp. 133 - 138
• Main Authors: Martinez, Rafael C. R, Franceschini, Sílvio A, Patta, Maristela C, Quintana, Silvana M, Gomes, Bruna C, De Martinis, Elaine C. P, Reid, Gregor
• Format: Journal Article
• Language: English
• Published: Ottawa, ON National Research Council of Canada 01.02.2009; NRC Research Press; Canadian Science Publishing NRC Research Press
• Subjects: Adolescent; Adult; Anti-infective agents; Antibiotics; bacterial vaginosis; Bacteriology; Biological and medical sciences; Brazil; Dosage and administration; Double-Blind Method; Drug therapy; Female; Fundamental and applied biological sciences. Psychology; Health aspects; Humans; Infections; Lactobacillus; Lactobacillus reuteri - physiology; Lactobacillus reuteri RC-14; Lactobacillus rhamnosus - physiology; Lactobacillus rhamnosus GR-1; Microbiology; Middle Aged; Miscellaneous; Patient outcomes; Placebos; probiotic; Probiotics; Probiotics - administration & dosage; probiotique; Risk factors; Studies; Tinidazole; Tinidazole - administration & dosage; Treatment Outcome; Urogenital system; Vagina - microbiology; vaginite bactérienne; Vaginosis; Vaginosis, Bacterial - drug therapy; Vaginosis, Bacterial - microbiology; Womens health; Young Adult; Brazil; Probiotic; Nitro compound; Imidazole derivatives; Lactic acid bacteria; Vaginal diseases; Vaginitis; Female genital diseases; Infection; Antiprotozoal agent; Bacterial vaginosis; Tinidazole; Bacteriosis; Bacteria; Lactobacillaceae; Parasiticide; Lactobacillus rhamnosus
• ISSN: 0008-4166; 1480-3275
• DOI: 10.1139/W08-102

Bacterial vaginosis (BV) is the most prevalent vaginal infection worldwide and is characterized by depletion of the indigenous lactobacilli. Antimicrobial therapy is often ineffective. We hypothesized that probiotic Lactobacillus rhamnosus GR-1 and Lactobacillus reuteri RC-14 might provide an adjunct to antimicrobial treatment and improve cure rates. Sixty-four Brazilian women diagnosed with BV were randomly assigned to receive a single dose of tinidazole (2 g) supplemented with either 2 placebo capsules or 2 capsules containing L. rhamnosus GR-1 and L. reuteri RC-14 every morning for the following 4 weeks. At the end of treatment (day 28), the probiotic group had a significantly higher cure rate of BV (87.5%) than the placebo group (50.0%) (p = 0.001). In addition, according to the Gram-stain Nugent score, more women were assessed with "normal" vaginal microbiota in the probiotic group (75.0% vs. 34.4% in the placebo group;; p = 0.011). This study shows that probiotic lactobacilli can provide benefits to women being treated with antibiotics for an infectious condition.