The Effectiveness of Adding Probiotic to Antimicrobial Agents for the Treatment of Bacterial Vaginosis: A Systematic Review

Background: Common antimicrobial regimens for treating bacterial vaginosis often cause recurrence and bacterial resistance. Previous studies have reported thata combination of antimicrobial and probiotic consisting of Lactobacillus spp. is an effective treatment for recurrent bacterial vaginosis. Lactobacillus plays an important role in vaginal health byreplacing the pathogenic colonies in vagina. This study aimed to determinethe effectiveness of adding probiotic toantimicrobial therapeutic for theprevention of bacterial vaginosis(BV) recurrence. Subjects and Method: A systematic review was conducted by searching the following databases: PubMed, Science Direct, Web of Science, Springer Link and the Cochrane. The review included randomized controlled trials (RCTs) conducted in primary hospitals and private clinics. The Amsel criteria and Nugent score were used for diagnosis appraisal of bacterial vaginosis. were included in this systematic review consisting of the two types of bacterial vaginosis treatment. All pooled data analyses were based on random-effects models and intention to treat (ITT). Data were analyzed using Rev Man 5 software. Results: The review included 5 RCTs involving 692 women on reproductive age underwent treatment of BV for 5 days or more.The studies showed that combination of probiotic and antimicrobial treatment reduced the risk of bacterial vaginosis recurrence a half time compared to antimicrobial treatment alone(RR= 0.49; 95% CI= 0.17 to 1.44). Conclusion: Adding probiotic to antimicrobial regimens is more effective than antimicrobial regimens alone for treating bacterial vaginosis recurrence. Keywords: probiotic, antimicrobial, bacterial vaginosis recurrence, randomized controlled trial Correspondence: Aquartuti Tri Darmayanti. Masters Program in Public Health, Sebelas Maret University, Jl. Ir. Sutami 36 A, Surakarta 57126, Central Java. Email: tutiaquar@gmail.com