Lactobacillus Replacement Therapy for Preventing Recurrent Vaginal Dysbiosis

Vaginal dysbiosis (also known as bacterial vaginosis) is characterized by displacement of optimal vaginal microflora by diverse bacteria, often recurs after therapy, and has been associated with multiple adverse health outcomes. To assess whether intravaginal replacement of Lactobacillus crispatus, a bacterium associated with optimal vaginal health, reduces risk for recurrence, investigators performed a double-blind, placebo-controlled NIH-funded trial in 228 women who had recently received metronidazole for dysbiosis. The women used prefilled applicators to self-administer a commercial preparation of intravaginal powder (not yet FDA-approved) containing L. crispatus or placebo for 4 consecutive days during the first week, then twice weekly…