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SAFETY AND EFFICACY OF COMBINED ANTIBIOTIC AND PROBIOTIC THERAPY IN TREATMENT OF BACTERIAL VAGINOSIS

Fakharunissa Waheed, Roshan Ara Kazi and Qamarunissa Muhabat

Background: Bacterial vaginosis is a common condition and the associated disease burden is rising every year. As successful as the traditional antibiotic is, supplementation with modern approach may help lessen the disease burden. One such approach is oral or vaginal instillation of probiotic which stems from the observed dominance of lactobacilli in healthy vaginal microbiota and its depletion in bacterial vaginosis (BV). Objective: To determine the safety and efficacy of combined antibiotic and probiotic therapy in the management of bacterial vaginosis. Methodology: This prospective cohort was conducted upon a sample of 100 premenopausal women diagnosed with BV. The study subjects were treated with oral metronidazole (500 mg) twice daily from days 1 to 7, and randomized to receive oral probiotic (lactobacillus) or placebo twice daily from days 1 to 30. Primary outcome was cure of BV as determined by normal Nugent score, negative sialidase test and no symptoms or signs of BV at day 30. The data obtained was recorded onto a structured questionnaire and analyzed using SPSS v.21 & Microsoft Excel 2016. Results: The mean age of the women mothers stood at 33 (SD ± 6). The success (achievement of cure of BV as determined by normal Nugent score, absence of clue cells, negative sialidase test, no symptoms or signs and no discharge or odor at day 30) rate of the treatment stood at 88% for the combined treatment group and 40% for the antibiotic/placebo group (p < 0.001). Conclusion: After careful consideration, it can be concluded that combined therapy is safe and more efficacious than lone antibiotic. Thus use of probiotics should be routinely employed for the treatment of BV. Key Words: Bacterial Vaginosis, Lactobacillus, Metronidazole, Probiotic & Antimicrobial.

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