Probiotic strategies for the treatment and prevention of bacterial vaginosis

Roderick A. MacPhee, Ruben Hummelen, Jordan E. Bisanz, Wayne L. Miller, Gregor Reid

    Research output: Contribution to journalReview articlepeer-review

    58 Scopus citations


    Importance of the field: Urogenital infections are on average the number-one reason for women to visit the doctor. Yet, treatment and preventive strategies have gone unchanged for close to 50 years. With prevalence rates for bacterial vaginosis at more than 29%, depending on the population, and similarly high incidences of vulvo-vaginal candidiasis and urinary tract infections, plus HIV, new therapies are urgently needed to improve the health of women around the world. Areas covered in the review: This review discusses the vaginal microbiota, our improved understanding of its composition, and its role in health and disease. It also discusses the progress made in the past 10 years or so, with the development and testing of probiotic lactobacilli to improve vaginal health and better manage urogenital infection recurrences. What the reader will gain: The reader will have an understanding of the clinical data obtained so far, and the potential mechanisms of action of probiotics. Despite the need for more clinical studies, the review illustrates a case for inclusion of probiotics as part of the approach to disease prevention, and as an adjunct to antimicrobial treatment. Challenges remain in optimizing clinical benefits, selecting new strains, preparing new products and having them tested in humans then approved with informative claims, and making products readily accessible to women in the developed and developing world. Take home message: The vaginal microbiota is a complex structure that can change quickly and dramatically, and significantly impact a woman's health. New health-maintenance and disease-treatment approaches are badly needed, and probiotics should be considered.

    Original languageEnglish (US)
    Pages (from-to)2985-2995
    Number of pages11
    JournalExpert Opinion on Pharmacotherapy
    Issue number18
    StatePublished - Dec 2010

    All Science Journal Classification (ASJC) codes

    • Pharmacology
    • Pharmacology (medical)

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