Background: The aim of this study was to investigate the colonisation by lactobacilli and clinical outcome in\nwomen with bacterial vaginosis (BV) and recurrent vulvovaginal candidiasis (R-VVC) receiving antibiotic or\nanti-fungal treatment in combination with the probiotic EcoVag�® capsules.\nMethods: A total of 40 Scandinavian women diagnosed with BV or VVC on the basis of Amselâ��s criteria or clinical\nsymptoms were consecutively recruited in two pilot open label clinical trials. In trial I, women with BV were treated with\nclindamycin and metronidazole followed by vaginal EcoVag�® capsules, containing Lactobacillus rhamnosus DSM 14870\nand Lactobacillus gasseri DSM 14869, for 5 consecutive days after each antibiotic treatment. In trial II, women were\nrecruited in three groups as follows: women with BV receiving clindamycin and metronidazole treatment together\nwith a prolonged administration of EcoVag�® (10 consecutive days after each antibiotic treatment followed by weekly\nadministration of capsules for next four months), women with R-VVC receiving extended fluconazole and EcoVag�®\ntreatment, and women receiving extended fluconazole treatments only. The difference in frequency of isolation of\nEcoVag�® strains or other lactobacilli between groups was compared by Fisherâ��s exact test.\nResults: The 6-month cure rate for BV was 50 % in trial I while both the 6- and 12-month cure rates were 67 % in\ntrial II. The 6- and 12-month cure rates for VVC were 100 % and 89 % in women receiving fluconazole and EcoVag�®,\nand 100 % and 70 % in women receiving fluconazole only. The frequency of isolation of any Lactobacillus species\nduring the course of the study was associated with cure of BV in trial I and II, whereas the frequency of isolation of\nEcoVag�® strains was significantly associated with the cure of BV in trial II only. As previously observed, a change in\nsexual partner was associated with relapse of BV with an Odds ratio of 77 (95 % CI: 2.665 to 2225).\nConclusions: The study suggests that the treatment with antibiotics or anti-fungal medication in combination\nwith EcoVag�® capsules provide long-term cure against BV and R-VVC as compared to previous reports.
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