Date of Award

2024

Document Type

Scholarly Project

Degree Name

Master of Physician Assistant Studies (MPAS)

Department

Physician Assistant Studies

First Advisor

Solberg, Julie

Keywords

Vaginal Diseases, Vaginal Infections, Vaginitis, Vaginal discharge, Vaginal Microbiome, Probiotics

Abstract

Bacterial vaginosis (BV) is a common presenting complaint in healthcare, and patients often experience recurrences at a frustrating rate. The mainstay of current treatment is antibiotic therapy, either via oral or vaginal route. When recurrences occur, stronger antibiotics are often employed. This current method of treatment does not address an underlying component that impacts infection recurrence and rate of recurrence- the patient’s baseline vaginal microbiome and the healthy bacteria that support it. To determine the efficacy and safety of probiotic therapy for the treatment of bacterial vaginosis, a literature review was completed using databases PubMed and Embase. The results of this literature review confirm that probiotic therapy is safe for the treatment of BV, and more effective than antibiotics alone. There are a variety of different probiotic bacterial strains and concentrations utilized for either monotherapy to treat BV or in conjunction with antibiotic therapy. Of the bacterial strains analyzed, those that were most studied were L. crispatus and L.rhamnosus. Strains that showed the strongest efficacy regarding reducing recurrence of bacterial vaginosis were L. rhamnosus, L. fermentum, and L. planterum. Both oral route and vaginal route of probiotic treatment were shown to be effective. Vaginal route showed a faster impact on microbiome, but also a faster rate of recurrence than oral probiotic use. Further research is needed regarding identifying all possible bacterial strains that are beneficial in treating/preventing BV, differing combinations of strains for increasing efficacy, along with identifying the necessary concentrations of these strains.

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