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Probiotics for the Treatment of Bacterial Vaginosis: A Meta-Analysis

by Ziyue Wang 1,2,3,†, Yining He 1,4,5,† and Yingjie Zheng 1,4,5,*
Department of Epidemiology, School of Public Health, Fudan University, Shanghai 200032, China
Department of Health Policy and Management, School of Public Health, Peking University Health Science Center, Beijing 100191, China
China Center for Health Development Studies, Peking University, Beijing 100191, China
Key Laboratory of Health Technology Assessment, National Health Commission (Fudan University), Shanghai 200032, China
Key Laboratory of Public Health Safety, Ministry of Education, School of Public Health, Fudan University, Shanghai 200032, China
Author to whom correspondence should be addressed.
These two authors contributed equally to this work and should be regarded as co-first authors.
Int. J. Environ. Res. Public Health 2019, 16(20), 3859;
Received: 8 September 2019 / Revised: 10 October 2019 / Accepted: 11 October 2019 / Published: 12 October 2019
Background: The effect of probiotic therapy on bacterial vaginosis (BV) is controversial. We conducted a meta-analysis of the efficacy and safety associated with probiotic treatment for BV. Methods: We searched multiple databases covering up to 1 March 2018. Studies published as blinded randomized controlled trials (RCTs), comparing treatment using probiotic versus active or placebo control in BV patients were included, with at least one-month follow-up. Random effects model and trial sequential analysis (TSA) were applied. Results: Ten studies (n = 2321) were included. Compared with placebo, the probiotics-only therapy resulted in a beneficial outcome both in clinical cure rate at the 30th day (risk ratio, RR = 2.57; 95% confidential interval, 95% CI: 1.96 to 3.37), and Nugent score (mean difference, MD = −2.71; 95% CI: 3.41 to −2.00). This effect decreased but remained significant after eight weeks. Probiotics-post-antibiotics therapy had a decreased effect only for a short term and possibly among studies with a mostly black study population. No extra adverse events were observed. The TSA suggested a larger sample size for effective evaluation of the probiotics as a supplementary remedy. Conclusions: Probiotic regimes are safe and may exhibit a short-term and long-term beneficial effect for BV treatment. The ethnic-specific result for the probiotic used after antibiotics is worthy of further study. View Full-Text
Keywords: probiotic therapy; bacterial vaginosis; meta-analysis probiotic therapy; bacterial vaginosis; meta-analysis
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Wang, Z.; He, Y.; Zheng, Y. Probiotics for the Treatment of Bacterial Vaginosis: A Meta-Analysis. Int. J. Environ. Res. Public Health 2019, 16, 3859.

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