Background: Lactobacilli dominate the vaginal microbiota and are essential to its health. Various causes can reduce lactobacilli, allowing harmful bacteria to thrive and cause bacterial vaginosis. BV causes most vaginal discharge and odor in reproductive-age women and is associated with considerable morbidity. Several recent clinical trials have examined whether oral or intravaginal lactobacilli with or without antibiotics can enhance treatment outcomes and prevent BV recurrence. This study examined how Lactobacillus rhamnosus treats and prevents bacterial vaginosis. Patients and Methods: Using Amsel's criteria and Nugent score, 60 BV patients were included. Two groups of patients were formed. Group 1 got oral metronidazole 500 mg twice daily and vaginal capsules with L. rhamnosus (10¹⁰ CFU) twice daily for seven days. Only seven days of oral metronidazole 500 mg twice daily was given to Group 2. Patients were examined after 14 days using Amsel's criteria and Nugent score to reflect symptom improvement and satisfaction. After one month, patients were called to assess recurrence. Results: After two weeks, the probiotic plus metronidazole group exhibited higher improvement, with lower vaginal pH (−1.2 vs −0.5) and mean Amsel score (−2.5 vs −1.6). Post-treatment vaginal discharge did not differ between groups. Better patient satisfaction and symptom relief were in the probiotic group. After one month, group 1 (10.7%) had less recurrence than group 2 (70%). The higher cost diminished cost-effectiveness notwithstanding these gains. Conclusion: The findings suggest that Lactobacillus rhamnosus may enhance treatment response and reduce recurrence of bacterial vaginosis, although further studies are needed to confirm its cost-effectiveness.
*1Haider B. Al- Shammaa, 2Reem Mohammed Badea Al-Badri, 3Aminah Hilal Khallaf (Sat,) studied this question.