Efficacy of standard therapy with synbiotic or without synbiotic to reduce Gardnerella vaginalis, Atopobium vaginae and Megaesphaera phylotype I in pregnant women with bacterial vaginosis

Abstract

Objective: To evaluate whether addition of symbiotic to clindamycin could reduce Gardnerella vaginalis, Atopobium vaginae, and Megasphaera phylotype I in pregnant women with bacterial vaginosis. Methods: This randomized controlled trial (RSUP Dr. Wahidin Sudirohusodo Makassar clinical trial registry UH17010021) included 61 samples. The intervention group was given clindamycin and synbiotic while the control group was given clindamycin and placebo (without synbiotic). Wilcoxon test and hypothesis test of two independent samples were used to compare the treatment efficacy. Results: This study showed a significant difference in Nugent score before and after treatment in each group. But there was no difference in Nugent score between the intervention group and the control group after treatment or in Nugent scores reduction in both groups. The most common type of bacteria found was Megasphaera phylotype I. There were no significant differences in the three types (Gardnerella vaginalis, Atopobium vaginae, and Megasphaera phylotype I) of bacteria after treatment between both groups. Additionally, there was no difference in therapeutic effect between the intervention group and the control group. Conclusions: Clindamycin along with synbiotics is no more effective for treated bacterial vaginosis than clindamycin without synbiotics. Megaesphaera is the most commonly found bacteria, which cannot be eradicated with clindamycin.

Keywords

• bacterial vaginosis; synbiotic; nugent score; amsel criteria