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Bacterial Vaginosis Home Remedies. Proposed BV Treatment options .

Krasnopolskya, Vera N. Prilepskayab, Franco Polattic, Nina V. Zarochentsevaa, Guldana R. Caesar Pipe Stress Analysis Software Free Download. Bayramovab, Maurizio Caserinid, Renata Palmierid, e- Treatment overview during trials: Within 2. BV by metronidazole or clindamycin, implement vitamin C for six consecutive monthly cycles. Each cycle consists of inserting one vaginal tablet for 6 consecutive days during each month following menses . Conclusion was that the regular use of the tablets for the suggested duration following the success of metronidazole treatment reduces the reoccurrence rate from 3.

A therapeutic approach in the treatment of BV relapse is to re- establish and maintain the physiological acidity of the vagina, as the growth of anaerobes and other faecal bacteria is inhibited by low p. Mozart Effect Music Babies Download Adobe. H. Attempts to achieve this via re- colonisation with exogenous lactobacilli have not been successful.

Another, more accepted approach is to reduce vaginal p. H, in order to create a negative environment for pathogen growth and to achieve long- lasting normalisation of vaginal flora using intravaginal ascorbic acid (vitamin C). The use of antibiotics may induce resistance in the pool of bacteria recognised to cause BV and, conversely, could affect the normal flora of lactobacilli . Ascorbic acid . The mechanism of action is simple: through the lowering of vaginal p. H to the physiological level of 3.

Considering the time to the first BV relapse, treatment of at least five cycles is necessary in order to reduce, at a significant level, the risk of BV recurrence. As this was a prophylaxis study, in women who at the screening visit were healthy and who terminated the study in case of relapse, a between- treatment difference in clinical parameters was not expected. At the same time, differences in p. H were not expected but conversely, a reduction in p. H was noted for 3- month and 6- month treatment.

However, it is certain that BV involves the presence of a thick vaginal multi- species biofilm, where G. Similar to what happens in many other biofilm- related infections, standard antibiotics, like metronidazole, are unable to fully eradicate the vaginal biofilm, which can explain the high recurrence rates of BV. Furthermore, antibiotic therapy can also cause a negative impact on the healthy vaginal microflora. These issues sparked the interest in developing alternative therapeutic strategies. This review provides a quick synopsis of the currently approved and available antibiotics for BV treatment while presenting an overview of novel strategies that are being explored for the treatment of this disorder, with special focus on natural compounds that are able to overcome biofilm- associated antibiotic resistance.”Current available treatments.

Metronidazole and clindamycin are shown to be effective against anaerobic microorganisms, though tinidazole was the most recently approved antimicrobial agent for BV treatment, and is considered an alternative antimicrobial agent, particularly whenever metronidazole and clindamycin are unavailable or not tolerated. Being a second generation nitroimidazole with a longer half- life than metronidazole, it requires lower dosages, to be taken less frequently than metronidazole. Although antibiotics are effective against anaerobic microorganisms, the have an inability to completely eradicate the densely- structured polymicrobial BV biofilms- associated bacteria G. Vaginalis. Alternative solutions: Probiotics have been shown to modulate vaginal microbiota: “In the human vagina, certain Lactobacillus strains can act as probiotics, preventing the growth of BV- associated bacteria through two main mechanisms: the inhibition of pathogens adhesion to vaginal epithelium (Machado et al., 2. Mastromarino et al., 2. Boskey et al., 2. Aroutcheva et al., 2.

Diverse pharmaceutical formulations containing probiotic lactobacilli strains have reduced BV symptoms, improved the vaginal microflora profile, being usually well- tolerated (Rossi et al., 2. Hantoushzadeh et al., 2.

Facchinetti et al., 2. Vujic et al., 2. 01. Vicariotto et al., 2. Alternatively, probiotics have been proposed as adjuvants to antibiotic therapy . Several combinations of metronidazole, clindamycin or tinidazole with lactobacilli probiotic preparations have displayed promising results in BV treatment since they have been associated with high cure rates, low recurrence or quick re- establishment of an healthy vaginal microflora (Marcone et al., 2. Bodean et al., 2.

Recine et al., 2. Probiotics have also been used in an attempt to specifically deal with BV biofilms. Remarkably, in 2. Saunders and colleagues showed that L. Later, Mc. Millan and colleagues demonstrated that probiotic L. These findings provide some evidence of how lactobacilli probiotics might interfere with an abnormal vaginal microflora, reinforcing the hypothesis that probiotics could eradicate vaginal pathogenic biofilms and restore the normal microflora in in vivo situations.”“It has also been proposed that prebiotics . Interestingly, Rousseau and colleagues demonstrated that prebiotic preparations containing oligosaccharides were able to promote the growth of beneficial lactobacilli strains but not of the pathogenic microorganisms often found in urogenital infections including G.

In that study, the prebiotic gel displayed a similar therapeutic cure rate to metronidazole, having a major advantage of quicker restoration of the normal vaginal microflora. Recently, Coste and colleagues evaluated the efficacy and safety of another prebiotic gel, applied as adjuvant therapy .

Interestingly, Braga and colleagues showed that thymol, a molecule present in thyme essential oil, had an inhibitory effect upon both newly formed and mature G. Furthermore, the expectations on essential oils as effective agents against BV- biofilms can be inferred from studies in other related vaginal biofilms (Palmeira- de- Oliveira et al., 2. Bogavac et al., 2. Other studies reported an effective and safe use of vaginal vitamin C tablets in BV treatment (Petersen et al., 2.

H and microflora, especially in pregnant women (Zodzika et al., 2. Additionally, the regular use of vitamin C during 6 days per month, for 6 months after successful BV treatment, was shown to decrease the risk of BV recurrence (Krasnopolsky et al., 2. Another alternative comes in the form of buffering agents.

Polycarbophil . Recently, Reichman and colleagues reported that the use of boric acid in combination with a nitroimidazole reduce the BV recurrence (Reichman et al., 2. BV biofilms. However, this need to be further studied and in vitro biofilm experiments will elucidate the role of boric acid in BV prevention.”Conclusions and future directions: BV current approved therapies are not sufficient to deal with this multi- species biofilm- related vaginal disorder.

Future, research should address biofilm communities with a particular emphasis on multi- species biofilms, a topic that only recently emerged (Castro and Cerca, 2. By properly addressing the complex interactions established in multi- species biofilms, novel strategies will hopefully overcome the high recurrence and relapse rates associated with BV.