Impact of a lactobacilli-containing gel on vulvovaginal candidosis and the vaginal microbiome
Open accessAbstract
Vulvovaginal candidosis (VVC) is a common condition with severe symptoms and high recurrence rates. Probiotic lactobacilli are explored as alternatives to azole treatments. Although the vaginal microbiota is generally not depleted in lactobacilli during VVC, studies indicate that the functionality and antimicrobial activity of the lactobacilli is impaired. We selected three strains from the Lactobacillus genus complex (L. rhamnosus GG, L. pentosus KCA1 and L. plantarum WCFS1) based on in vitro evaluation and formulated them in a gel for vaginal application. This gel was evaluated in 20 patients suffering from acute VVC, who were followed for four weeks including a 10-day treatment period. The microbiome was assessed through 16S rRNA (bacteria) and internal transcribed spacer (ITS; fungi) amplicon sequencing, supplemented with quantitative PCR, culture and microscopy for Candida evaluation. 45% of women did not require rescue medication (3×200 mg fluconazole), implying an improvement of their symptoms. These women showed similar end concentrations of fungi as women treated with fluconazole. Moreover, fluconazole appeared to reduce numbers of endogenous lactobacilli. Our study points towards important aspects for future selection of lactobacilli for probiotic use in VVC and the need to investigate possible negative influences of azoles on the vaginal bacterial community.
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In patients with improvement with probiotics, lactobacilli were increased and fungi decreased as compared with women having received rescue medication with fluconazole.
“The author found that, in 45% of the cases, no rescue medication was needed (Donders et al., 2020) and, in patients with improvement with probiotics, lactobacilli were increased and fungi decreased as compared with women having received rescue medication with fluconazole (Oerlemans et al., 2020).”
From Management of recurrent vulvovaginal candidosis: Narrative review of the literature and European expert panel opinion (2022) · cites this paper as Oerlemans et al., 2020
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- Authors
- Oerlemans, E. F. M., Bellen, G., Claes, I., Henkens, T., Allonsius, C. N., Wittouck, S., van den Broek, M. F. L., Wuyts, S., Kiekens, F., Donders, G. G. G., & Lebeer, S.
- Affiliations
- University of Antwerp (BE)
- Antwerp University Hospital (BE)
- Corresponding author
- Lebeer, Sarah
- ORCID
- Venue
- Scientific Reports
- Published
- 2020-05-14
- Volume
- 10
- Issue
- 1
- Pages
- 7976-7976
- ISSN
- 2045-2322 (ISSN-L)
- PMC
- PMC7224289
- OpenAlex
- W3025068571
- Cited by
- 66
- References
- 53
- Citations by year
- 2026: 12 · 2025: 18 · 2024: 11 · 2023: 9 · 2022: 10 · 2021: 5 · 2020: 1
- FWCI
- 4.51
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- Scientific Reports (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Funders
- Fonds Wetenschappelijk Onderzoek (1503516N, 1517916N, 1520114N)
- Agentschap Innoveren en Ondernemen (IWT-SB 141198, IWT140919, IWT/50052)
- Topics
- Life Sciences › Immunology and Microbiology › Microbiology › Reproductive tract infections research
- Life Sciences › Agricultural and Biological Sciences › Food Science › Probiotics and Fermented Foods
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Gut microbiota and health
- Keywords
- probiotic lactobacilli, vaginal gel, vaginal microbiota, Lactobacillus rhamnosus GG, Lactobacillus pentosus, Lactobacillus plantarum, Candida, fluconazole, probiotic formulation, candidiasis treatment
- MeSH terms
- Proof of Concept Study, Administration, Topical, Antifungal Agents, Candidiasis, Vulvovaginal, Female, Humans, Lactobacillus, Vagina, Vaginal Creams, Foams, and Jellies, Treatment Outcome, Probiotics, Microbiota
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