Is the lactobacillus effective against CVV recurrence: systematic review of clinical trials? Švitrigailė Grincevičienė1, Jonas Grincevičius1, Povilas Kavaliauskas2,

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Presentation transcript:

Is the lactobacillus effective against CVV recurrence: systematic review of clinical trials? Švitrigailė Grincevičienė1, Jonas Grincevičius1, Povilas Kavaliauskas2, Arūnas Savickas1, Jurga Bernatonienė1 1 Lithuanian University of Health Sciences, 2 Vilnius University Introduction High incidence rate of recurrence CVV. Azoles could have adverse drug reactions. Fluconazole – limited option. Probiotics are considered as supplemental treatment. The aim: to analyze the evidence of effectiveness of lactobacillus as supplemental option in prevention of recurrent CVV. Results Materials and Methods Study design: a systematic review of clinical trials. Definition: patients (without comorbidities) with 4 or more candida vaginitis during last year. Intervention: lactobacillus use for supplementary treatment. Outcome: symptoms free. Databases: MEDLINE via PubMed, CINAHL via EBSCO. Time: from 1992 up to June 1, 2015. Searching technique: PICO, citations search. Inclusion: RCT, observation - 6 months. Limitation of research: long-term of observation, rare outcomes, small number of RCT. Sample: 3 studies (141 patients) (3 RCT). . Conclusions Supplemental treatment of Lactobacillus could 3.9 times improve the odds of being symptom free from recurrence CVV for 6 months. Larger studies are necessary to confirm the results, because a meta-analysis of several small studies does not predict the results of a single large study. TERMS: (yeast infection OR candida vulvovaginitis OR Vulvovaginal Candidiases OR Vulvovaginal Candidiasis OR Moniliasis, Vulvovaginal OR vulvovaginal Moniliases OR Vulvovaginal Moniliasis OR Vaginitis, Monilial OR Monilial Vaginitides OR Monilial Vaginitis OR Vaginitides, Monilial OR candida OR albicans OR glabrata OR parapsilosis OR krusei) AND (lactobacillus OR probiotics OR probiotic OR l. reuteri OR l. rhamnosus OR l. casei OR l. acidophilus OR l. plantarium OR l. fermentum OR l. gasseri OR Streptococcus thermophilus OR L. delbrueckii bulgaricus) AND (Placebo OR no tretment OR Control Group OR Group, Control OR Groups, Control OR Supplemental OR treatment OR therapy OR use) AND (recurrent OR disease free OR symptom free OR symptoms free OR subjective OR Recurrence OR Recurrences OR Recrudescence OR Recrudescences OR Relapse OR Relapses) References Sobel JD, Wiesenfeld HC, Martens M, et al. Maintenance fluconazole therapy for recurrent vulvovaginal candidiasis. N Engl J Med. 2004;351:876–883. Marchaim D, Lemanek L, Bheemreddy S, Kaye KS, Sobel JD. Fluconazole-Resistant Candida albicans Vulvovaginitis. Obstet Gynecol 2012;120:1407–14. Lewis JH, Zimmerman HJ, Benson GD, et al. Hepatic injury associated with ketoconazole therapy: analysis of 33 cases. Gastroenterology. 1984;86:503–513. Falagas ME, Betsi GI, Athanasiou S. Probiotics for prevention of recurrent vulvovaginal candidiasis: a review. J Antimicrob Chemother. 2006;58:266–272.