Recurrent BV (Bacterial Vaginosis)

BV (Bacterial Vaginosis) Management = Treat infection + Prevent Recurrence

Bacterial vaginosis affects 15 to 50% of women of reproductive age, and recurrence is common after treatment with an antibiotic agent.

The high incidence of recurrence suggests the need for new treatments to prevent recurrent bacterial vaginosis.

The vaginal microbiome of most women is dominated by particular Lactobacillus species that play an important role in reproductive health by reducing the risk of urogenital infections and complications during pregnancy.

Dysbiosis is a disruption of the vaginal microbial ecosystem with a loss of protective hydrogen peroxide-producing Lactobacillus and a marked increase in microbial diversity.

Epidemiological studies have shown that vaginal dysbiosis is associated with Bacterial Vaginosis (BV) and recurrent Urinary Tract Infection.

Dysbiosis is also associated with sexually transmitted infections, including HIV, preterm birth, and low success rates for in vitro fertilization (IVF).

Antibiotics are used to treat urogenital infections, but recurrences are common.

After treatment with an antibiotic agent, about 50 % of women have recurrent bacterial vaginosis within 3 months.

Antibiotics kill the bacteria that cause these infections, but they do not prevent recurrence of infection since they do not restore protective Lactobacillus.

Reconstituting a normal, Lactobacillus-predominant vaginal flora remains a challenge to develop microbial defence against pathogens.

L.crispatus is found naturally in the vaginas of healthy women and is commonly found as a component of the natural human intestinal flora. It is facultative anaerobe, homofermentor of lactic acid, fastidious in its growth, and capable of H2O2 production.

Use of oestrogen-containing contraception may be protective. The use of combined oral contraception is linked to increased vaginal colonization with Lactobacilli and reduced BV-associated microbiota.