Bacterial vaginosis (BV) is a disease caused by vaginal microbiota dysbiosis. The conventional antibiotic treatment can aggravate microbial dysbiosis, alter the acid environment of the vagina and lead to drug resistance, thus shows low cure rate and high recurrence rate. This poses significant physiological and psychological burden to the BV patients. Vaginal microbiota transplantation (VMT) is a novel live biotherapeutic approach. It directly engrafts the whole vaginal microbiota from healthy women to the vaginal tract of patients to rapidly reconstruct the vaginal microbiota environment and restore the vaginal health. This article summarizes the development, present challenges, and future directions of using VMT, with the aim to explore new strategies for treatment of BV and promote the clinical use of VMT.
Dysbiosis/therapy* ; Female ; Humans ; Microbiota ; Vagina ; Vaginosis, Bacterial/therapy*

BACKGROUNDBacterial vaginosis (BV) is one of the most common infectious diseases among sexually active women and is associated with the increased acquisition of a variety of sexually transmitted diseases. This study aimed to compare the efficacy of a non-antibiotic sucrose gel against an antibiotic metronidazole gel for the treatment of BV.

METHODSA randomized, double-blinded, multi-center, parallel-group, placebo-controlled phase III clinical trial was conducted at eight hospitals in China. A total of 560 subjects with clinically diagnosed BV were randomly assigned into three groups for vaginally receiving sucrose, metronidazole, and placebo gels, respectively, twice daily for five consecutive days. The efficacy of therapeutic cure, defined as an achievement of both microbiologic cure (a Nugent score of 3 or less) and clinical cure (a resolution of the clinical findings from the baseline visit), was evaluated at the 1st and 2nd test-of-cure (TOC) visits at 7-10 and 21-35 days after the start of treatment, respectively.

RESULTSTherapeutic cure rates for sucrose, metronidazole, and placebo gel groups were 83.13%, 71.30% and 0.92%, at the 1st TOC, and 61.04%, 66.67% and 7.34%, at the 2nd TOC, respectively. While there was no significant difference between the sucrose and metronidazole gel groups at the 2nd TOC (P = 0.305), and sucrose gel was more effective than metronidazole gel at the 1st TOC (P = 0.009).

CONCLUSIONThese findings suggest that sucrose gel restores normal vaginal flora more rapidly than metronidazole gel and can be used as a novel treatment for BV.

Administration, Intravaginal ; Adolescent ; Adult ; Anti-Bacterial Agents ; administration & dosage ; therapeutic use ; Double-Blind Method ; Female ; Humans ; Metronidazole ; administration & dosage ; therapeutic use ; Middle Aged ; Sucrose ; administration & dosage ; therapeutic use ; Treatment Outcome ; Vaginosis, Bacterial ; drug therapy ; Young Adult

OBJECTIVEDiscussing the chitosan' medical efficiency to treat Gynecology bacteria infectious disease by researching the bacteriostasis, biocompatibility of chitosan and analyzing the chitosan' medical efficiency to Bacterial vaginosis by clinical examination.

METHODSThe antibiotic experiment of chitosan to Candida albicans (ATCC 10231), Escherichia Coli (ATCC 25922) and Golden staphylococcus (ATCC 6538) has been studied in this paper. The vaginal irritation experimentation of chitosan to female rabbit and the sensitization experimentation of chitosan to guinea pig also have been conducted. To study the curative effect, we also coat a layer of chitosan in 20 patients' vagina.

RESULTThe Antibacterial rate of chitosan to Candida albicans is more than 98% and to Escherichia Coli is more than 99% and to Golden staphylococcus is more than 99%. Cytotoxicity of chitosan to vagina mucosa is grade 1 and sensitization of chitosan to vagina mucosa is none and stimulation of chitosan to vagina mucosa is very slightly. The total efficiency rate to treat Gynecology bacteria infectious disease is 90% and the cure rate is 75%.

Animals ; Anti-Infective Agents ; pharmacology ; therapeutic use ; Candida albicans ; drug effects ; Chitosan ; pharmacology ; therapeutic use ; Escherichia coli ; drug effects ; Female ; Histocompatibility ; Microbial Sensitivity Tests ; Rabbits ; Staphylococcus ; drug effects ; Vaginosis, Bacterial ; drug therapy