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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,*
1
Department of Epidemiology, School of Public Health, Fudan University, Shanghai 200032, China
2
Department of Health Policy and Management, School of Public Health, Peking University Health Science Center, Beijing 100191, China
3
China Center for Health Development Studies, Peking University, Beijing 100191, China
4
Key Laboratory of Health Technology Assessment, National Health Commission (Fudan University), Shanghai 200032, China
5
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; https://doi.org/10.3390/ijerph16203859
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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