Probiotics are a good choice for the treatment of bacterial vaginosis: a meta-analysis of randomized controlled trial

Chen, Rongdan; Li, Rong; Qing, Wei; Zhang, Yingxuan; Zhou, Zuyi; Hou, Yi; Shi, Yiya; Zhou, Hongwei; Chen, Muxuan

doi:10.1186/s12978-022-01449-z

Reproductive Health

Table 1 Characteristics of the included studies in the meta-analysis

From: Probiotics are a good choice for the treatment of bacterial vaginosis: a meta-analysis of randomized controlled trial

Reference	Type of study	Age (Mean ± SD)	Sample size (Intervention/Control)	Intervention				Control				Follow-up time	Diagnosis criteria
Reference	Type of study	Age (Mean ± SD)	Sample size (Intervention/Control)	Probiotic type	Dosage	Drug-delivery way	Time	Antibiotic type	Dosage	Drug-delivery way	Time	Follow-up time	Diagnosis criteria
Anukam et al., 2006	R, DB, PC	18–44	106 (49/57)	L. rhamnosus gR-1, L. reuteri RC-14	10⁹ CFU × 2/d	Take orally	30d	Metronidazole	500 mg	Take orally	7 days	30 d	Nugent score 7–10
Anukam et al., 2006	R, DB, PC	18–44	106 (49/57)	Metronidazole	500 mg × 2/d	Take orally	7 d	Metronidazole	500 mg	Take orally	7 days	30 d	Nugent score 7–10
Bradshaw et al., 2012	R, DB, PC	18–50	268 (133/135)	L. acidophilus KS400	> 10⁷ CFU	Vaginally	12 d	Placebo	/	Vaginally	12 days	3 m	Nugent Score 7–10
Bradshaw et al., 2012	R, DB, PC	18–50	268 (133/135)	metronidazole	400 mg × 2/d	Take orally	7 d	Metronidazole	400 mg	Take orally	7 days	3 m	Nugent Score 7–10
Cohen et al., 2020	R, DB, PC	30.7 ± 6.8/ 31.4 ± 7.1	228 (133/64)	L. crispatus CTV-05	2 × 10⁹ CFU	Vaginally	30 d	Placebo	/	Vaginally	30 days	12 w	Amsel’s criteria ≥ 3
Cohen et al., 2020	R, DB, PC	30.7 ± 6.8/ 31.4 ± 7.1	228 (133/64)	metronidazole	0.75%	Vaginally	5 d	Metronidazole	0.75%	Vaginally	5 days	12 w	Amsel’s criteria ≥ 3
Eriksson et al., 2005	R, DB, PC	32 (20–52)/ 32 (18–53)	197 (91/96)	L. gasseri, L. casei rhamnosus, L. fermentum	10⁸ CFU	Vaginally	> 5 d	Placebo		Vaginally	> 5 days	28 d	Amsel’s criteria ≥ 3
Eriksson et al., 2005	R, DB, PC	32 (20–52)/ 32 (18–53)	197 (91/96)	Clindamycin	100 mg	Vaginally	3 d	Clindamycin	100 mg	Vaginally	3 days	28 d	Amsel’s criteria ≥ 3
Happel et al., 2020	R, OB	18–45	29 (18/11)	L. acidophilus, L. rhamnosus GG,	≥ 2 × 10⁹ CFU	Take orally&Vaginally	15d	Metronidazole	0.75%	Vaginally	5 days	5 m	Nugent score 7–10
Happel et al., 2020	R, OB	18–45	29 (18/11)	metronidazole	0.75%	Vaginally	5 d	Metronidazole	0.75%	Vaginally	5 days	5 m	Nugent score 7–10
Larsson et al., 2008	R, DB, PC	≥ 18	100 (50/50)	L. gasseri L. rhamnosus	≥ 10^8–9 CFU	Vaginally	10d	Placebo	/	Vaginally	10 days	30 d	Amsel’s criteria ≥ 3
Larsson et al., 2008	R, DB, PC	≥ 18	100 (50/50)	Clindamycin	2%	Vaginally	7 d	Clindamycin	2%	Vaginally	7 days	30 d	Amsel’s criteria ≥ 3
Laue et al., 2017	R, DB, PC	32.6 ± 11.2/ 39.0 ± 12.3	34 (17/17)	L. crispatus, L. gasseri, L. rhamnosus, L. jensenii	10⁷ CFU/ml × 2/d	Orally	4 w	Placebo	/	Orally	4 weeks	28 d	Amsel’s criteria ≥ 3
Laue et al., 2017	R, DB, PC	32.6 ± 11.2/ 39.0 ± 12.3	34 (17/17)	Metronidazole	500 mg × 2/d	Orally	7 d	Metronidazole	500 mg × 2/d	Orally	7 days	28 d	Amsel’s criteria ≥ 3
Marcone et al., 2008	R, NB	18–40	84 (42/42)	L. rhamnosus	> 40,000 CFU	Vaginally	Once a week /2 m	Metronidazole	500 mg × 2/d	Orally	7 days	180 d	Amsel’s criteria = 4
Marcone et al., 2008	R, NB	18–40	84 (42/42)	Metronidazole	500 mg × 2/d	Orally	7 d	Metronidazole	500 mg × 2/d	Orally	7 days	180 d	Amsel’s criteria = 4
Marcone et al., 2010	R, DB	18–45	46 (23/23)	L. rhamnosus	40,000 CFU	Vaginally	Once a week /6 m	Metronidazole	500 mg × 2/d	Orally	7 days	30 d	Amsel’s criteria = 4
Marcone et al., 2010	R, DB	18–45	46 (23/23)	Metronidazole	500 mg × 2/d	Orally	7 d	Metronidazole	500 mg × 2/d	Orally	7 days	30 d	Amsel’s criteria = 4
Martinez et al.,2009	R, DB, PC	30.0 ± 10.9/ 30.3 ± 10.7	64 (32/32)	L. rhamnosus GR-1, L. reuteri RC-14	1 × 10⁹ CFU	Orally	28 d	Placebo	/	Orally	28 d	28 d	Amsel’s criteria ≥ 3 & Nugent score 7–10
Martinez et al.,2009	R, DB, PC	30.0 ± 10.9/ 30.3 ± 10.7	64 (32/32)	Tinidazole	2 g	Orally	28 d	Tinidazole	2 g	Orally	28 d	28 d	Amsel’s criteria ≥ 3 & Nugent score 7–10
Ozmen et al., 1997b	R, NB	18–53	210 (96/114)	L. acidophilus	10⁷–7 × 10⁸ CFU	Vaginally	12d	Metronidazole	500 mg × 2/d	Orally	7 days	22–35 d	Amsel’s criteria ≥ 3
Ozmen et al., 1997b	R, NB	18–53	210 (96/114)	Metronidazole	500 mg × 2/d	Orally	7 d	Metronidazole	500 mg × 2/d	Orally	7 days	22–35 d	Amsel’s criteria ≥ 3
Petricevic et al., 2008	R, OB	18–45	171 (83/88)	L. casei rhamnosus	10⁹ CFU	Vaginally	7d	Clindamycin	300 mg × 2/d	Orally	7 days	28 d	Nugent score 7–10
Petricevic et al., 2008	R, OB	18–45	171 (83/88)	Clindamycin	300 mg × 2/d	Orally	7 d	Clindamycin	300 mg × 2/d	Orally	7 days	28 d	Nugent score 7–10
Russo et al., 2019	R, DB, PC	18–50	48 (24/24)	L. acidophilus GLA-14, L. rhamnosus HN001	5 × 10⁹ CFU	Orally	15 d	Placebo	/	Orally	15 days	6 m	Nugent score > 7
Russo et al., 2019	R, DB, PC	18–50	48 (24/24)	Metronidazole	500 mg × 2/d	Orally	7 d	Metronidazole	500 mg × 2/d	Orally	7 days	6 m	Nugent score > 7
Zhang et al., 2021	R, NB	18–65	99 (52/47)	L. rhamnosus GR-1 L. reuteri RC-14	≥ 1 × 10⁹ CFU	Orally	30 d	Metronidazole	0.2 g	Vaginally	7 days	90 d	Nugent score ≥ 7
Zhang et al., 2021	R, NB	18–65	99 (52/47)	metronidazole	0.2 g	Vaginally	7d	Metronidazole	0.2 g	Vaginally	7 days	90 d	Nugent score ≥ 7
Anukam, K. C et al.,2006	R	18–50	35 (17/18)	L. rhamnosus GR-1, L. reuteri RC-14	10⁹ CFU	Vaginally	5 d	Metronidazole	0.75%	Vaginally	5 days	30 d	Nugent score 7–10
Ling, Zongxin et al., 2013	R	/	55 (25/30)	L. delbrueckii(lactis DM8909)	≥ 10⁹ CFU	Vaginally	10 d	Metronidazole	500 mg	Vaginally	7 days	30d	Amsel’s criteria ≥ 3 &Nugent score7–10
Ozmen et al., 1997a	R, NB	18–53	211 (97/114)	L. acidophilus	10⁷–7 × 10⁸ CFU	Vaginally	12 d	Metronidazole	500 mg × 2/d	Orally	7 days	22-35d	Amsel’s criteria ≥ 3
Hallén et al.,1992	R, DB, PC	17–40	57 (28/29)	L. acidophilus	10^8–9 CFU	Vaginally	6 d	Placebo	/	Vaginally	6 days	20d	Amsel’s criteria ≥ 3
Mastromarino et al., 2009	R, DB, PC	33 ± 9.9/ 35 ± 9.2	34 (18/16)	L. brevis CD2, L. salivarius FV2, L. plantarum FV9	10⁹ CFU	Vaginally	7 d	Placebo	/	Vaginally	7 days	28d	Amsel’s criteria ≥ 3
Vicariotto et al., 2014	R, DB, PC	34.7 ± 8.9	34 (24/10)	L. fermentum LF15 L. plantarum LP01	4 × 10⁹ CFU	Vaginally	7 d	Placebo	/	Vaginally	7 days	28d	Amsel’s criteria ≥ 3 &Nugent score7–10

R: randomized; DB: double blind; PC: placebo controlled; NB: not blind; OB: observer blind; CFU: colony-forming units

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