Bacterial vaginosis: drugs versus alternative treatment

Bacterial vaginosis is one of the most common infectious disorders affecting women. It is caused by several microorganisms, including Gardnerella vaginalis, Bacteroides, beta-streptococci and mobiluncus/falcivibrio sp. Bacterial vaginosis is thought to occur as a result of a change in vaginal pH mediated by the metabolic activity of anaerobic bacteria. This rise in vaginal pH interferes with the activity of vaginal lactobacilli which maintain vaginal acidity. Several types of antibiotics have been used to treat this condition. Although metronidazole was found to be the most effective, none was completely successful in either cure or prevention. Several attempts have recently been made to treat bacterial vaginosis using physiological or 'natural' substances, such as lactate gel and commercial yoghurt, which is acidic and also contains lactobacillus strains. This kind of treatment looks promising and may have a place in certain clinical conditions, including pregnancy, in cases of recurrent inflammation, or as a prophylactic treatment before invasive gynecological procedures or abdominal surgery in patients known to be affected. This issue should be additionally studied and evaluated in light of the relatively little experience with this modality of treatment for bacterial vaginosis.