Clinical Question: Can lactobacillu...

Clinical Question: Can lactobacillus preparations, given orally, vaginally, or the couple prevent post-antibiotic vaginal candidiasis?

Setting: Outpatient (primary care)

cogitation Design: Randomized controlled trial (double-blinded)

Allocation: Concealed

Synopsis: Investigators evaluated the character of products containing Lactobacillus spp to stop vaginal candidiasis in 278 nonpregnant women who required a short course of antibiotics for a nongynecologic infection. The actual antibiotics were not specified. The women were assigned randomly, using concealed allocation, to receive an oral comminute containing Lactobacillus spp., a vaginal pessary containing Lactobacillus, the two treatments, or placebo. The women took the gunpowder twice daily 20 minutes before meals and used united pessary at night for 10 nights during the six-day course of antibiotics and for four days after. Viability of the lactobacilli was confirmed. Candida was cultur in 23 percent of the women a rate consistent with other research. The rate of vaginal candidiasis was similar in women receiving individual or both forms of probiotic or placebo. The contemplation ended early because of lack of benefit.

Bottom Line: Lactobacillus, given orally, vaginally, or the one and the other has no effect on the growth of culture-proven vaginal candidiasis. Lactobacillus probiotics are effective, however, in decreasing antibiotic-associated diarrhea (Cremonini F et al. Meta-analysis: the issue of probiotic administration on antibiotic-associated diarrheoea. Aliment Pharmacol Ther August 2002;16:1461-7) (Level of Evidence: 1b)

subject of attention Reference: Pirotta M, et al. result of lactobacillus in preventing post-antibiotic vulvovaginal candidiasis: a randomised controll trial. BMJ September 4 2004;329:548-51 Used with permission from Shaughnessy AF. Lactobacillus doesn't obstruct post-antibiotic vaginitis. Accessed online November 1 2004 at: http://www.InfoPOEMs.com.

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