Репродуктивная эндокринология (Dec 2023)
Probiotic combinations for women. Effectiveness and safety from the points of evidence-based medicine
Abstract
To date, probiotic medicinal products have a significant number of clinical studies, which is the basis for the formation of an evidence base and their inclusion in modern treatment standards. However, ideas about the optimal composition of a probiotic preparation and effective dosage remain problematic issues in modern medicine. Choosing an effective probiotic in gynecological practice is a particularly difficult and important issue. Objective of the review: to analyze the available clinical studies aimed at identifying strains of beneficial bacteria, their dosage, possible combinations in order to choose the optimal composition of a probiotic agent for the treatment of dysbiosis, including vaginal. Materials and methods. Modern methods recommended for theoretical analytical research were used: method of analysis, method of synthesis, method of induction. An electronic search was conducted in bibliographic databases, including PubMed, CENTRAL, MEDLINE, Embase, and CINAHL. 58 scientific publications were analyzed. Inclusion criteria were the following keywords: probiotics, optimal dosage, optimal composition, dysbiosis. Results. The most important probiotic microorganisms for restoring health in women are Lactobacillus acidophilus, L. crispatus, L. jensenii, L. gasseri, L. rhamnosus. Each of these lactobacilli maintains the normal vaginal pH, produces hydrogen peroxide, suppresses growth and prevents the reproduction of obligate anaerobes and opportunistic microorganisms when interacting with the peroxidase of cervical mucus. The mechanism of action of the above-mentioned probiotic microorganisms was analyzed. It was established that the effective dose of each of the components should not be less than 1-2 billion colony forming units. Conclusions. The analysis of scientific publications in the bibliographic databases was sufficient to establish that the oral use of probiotics in the treatment of gynecological patients is effective. The optimal components of the probiotic agent, which are effective for the therapy of vaginal dysbiosis, are L. crispatus, L. gasseri, L. jensenii, L. rhamnosus, L. acidophilus.
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