The vaginal capsules containing Lactobacillus rhamnosus and Lactobacillus gasseri could prevent relapses of bacterial vaginosis (BV) and recurrent vulvovaginal candidiasis (R-VVC) in women receiving antibiotic or anti-fungal treatment, according to the paper published in BMC Infectious Diseases.
Niels Peter Bak, business manager for EcoVag, told NutraIngredients: “Recurrent vaginal infections, notably BV, is a major concern with reported relapse rate of 80% nine months after initial treatment.”
He said the relapse rates were likely linked to the growing problem of antibiotic resistance, “which just makes the use of vaginal applied probiotics even more relevant as a possible mean of reducing the consumption of antibiotics [prescribed] for treatment of BV”.
He added: “Many people perceive vaginal infections as a nuisance, but experts agree that notably BV, if left untreated can have potential serious medical consequences, including pre-term delivery and increased risk of acquiring certain sexual transmitted diseases.”
Study details
Pendharkar and colleagues studied a total of 40 Scandinavian women diagnosed with BV or VVC, in two pilot open label clinical trials.
Trial one involved treating women with BV with antibiotics followed by EcoVag capsules for five consecutive days.
In the second trial the participants were divided into three groups: women with BV receiving antibiotics and prolonged (four months) administration of EcoVag; women with R- VVC receiving extended treatment with anti-fungal medication (fluconazole) and EcoVag and women with candidiasis receiving extended anti-fungal treatment only.
Results were collected from self-swab samples and analysis of cultures in the laboratory. The outcome measures were cure of BV and VVC and colonisation by Ecovag probiotic strains.
Results showed the Ecovag strains, or the women's own endogenous strains, were associated with the clear up of BV.
All women with candida in both groups treated with fluconazole alone or with Ecovag, were cured at the six months follow up.
When the relapse rate at 12 months was analysed, the group treated with Ecovag had a slightly higher cure rate (89%) than fluconazole alone (70%), although the results were not statistically significant.
The partners of women in the groups receiving antibiotics were also given oral clindamycin. The study found, as confirmed by previous reports, that relapse of BV was strongly associated with change of sexual partner.
The authors said: “Based on these results it can be stated that change in sexual partner is strongly associated with BV. This could be due to an increased sexual activity after change of partner or because BV may act as a STD.”
Further studies
The authors commented that further studies with larger cohorts using molecular methods for quantification of probiotic strains are needed.
“The impact of administration of EcoVag on the whole vaginal microbiome should also be measured to better understand how the administered EcoVag strains helps in restoring the normal microbiota and reduce relapse of BV and VVC.”
Bright future
Asked about how the product is marketed, Niels Peter Bak told us: “Recommendation of our product by GP’s, gynaecologists and pharmacists is paramount and fortunately there is an increasing awareness of the benefits of vaginal applied probiotics amongst these medical professionals.
"Consumer oriented marketing obviously is also taking place, but the product recommendation by medical professionals and pharmacists remains the most important driver for market growth.”
He said the product is often marketed under private label in 20 mostly European countries, with presence in the UK expected in 2016.
“The medical concerns linked to vaginal infections, notably BV, is a global and we are experiencing increased interest for Ecovag from markets outside Europe, including Asia, North & South America.
"The future for vaginal applied probiotics remain bright and with the initiatives undertaken to secure Ecovag as the leading product solution, Bifodan is in a good position to benefit from the market growth.”
Source: BMC Infectious Diseases
(2015) 15:255 doi:10.1186/s12879-015-0971-3
“Vaginal colonisation by probiotic lactobacilli and clinical outcome in women conventionally treated for bacterial vaginosis and yeast infection”
Authors: S. Pendharkar, E. Brandsborg, L. Hammarström, H. Marcotte and P. Larsson
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