Bacterial vaginosis (BV) is the most common infectious vaginitis, with a prevalence of 20% in women of reproductive age. BV is often described as a microbial imbalance with lactobacilli deficiency being the most significant factor, as there is no clear route of infection or single aetiological agent.
The primary symptoms are pruritus (itching), irritation, and a thin grey vaginal discharge. BV can however be asymptomatic in approximately 50% of patients.
Standard treatment for BV is oral antibiotics, however there are a number of side effects with these drugs, and of the patients who respond well to the antibiotic treatment, 69% will experience a recurrence of BV within a year. Compounding the problem is the increase in drug resistance of BV-related bacteria such as gardnerella resulting from the use of antibiotics for BV.
A combination of L. rhamnosus GR-1 and L. reuteri RC-14 have consistently been shown to successfully treat BV, with or without antibiotics. It appears they target pathogen growth and the biosurfactants produced by L. reuteri RC-14 may play a role in displacement. In vitro studies have shown that L. rhamnosus GR-1 and L. reuteri Rc-14 disrupt the biofilms of Gardnerella vaginalis and Atopobium vaginae, two pathogens often associated with BV.