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THE ROLE OF INTRAVAGINAL PREBIOTICS IN CONTROLLING THE EVOLUTION OF UNCOMPLICATED BACTERIAL AND FUNGAL VAGINAL INFECTIONS

Healthy vaginal flora is populated mainly by lactobacilli with an important role in protecting the host from urogenital infections. Conventional antimicrobial treatments have the risk of damaging healthy vaginal flora, which subsequently translates into significant recurrence rates. The aim of the study was to investigate if vaginal administration of α-glyco-oligosaccharides prebiotics, as specific nutritional support for lactobacilli, along with xylitol and hyaluronic acid could be considered as single treatment of uncomplicated vaginal infections (vaginitis or vaginosis) compared with classical antimicrobial preparations. The open-label, randomized, comparative study included 164 women between 18 and 66 years of age diagnosed with uncomplicated vaginal fungal or bacterial infections. Patients were randomized into 2 treatment groups: a prebiotic complex of α-glyco-oligosaccharides, hyaluronic acid, xylitol, herbal extracts, vitamin C and E for vaginal administration - group A, classic antimicrobial treatment with antibiotic and/or antifungal - group B. Patients have been evaluated before and 10 days after the start of treatment for symptomatic parameters (pruritus, burning, dyspareunia, dysuria, oedema, erythema, appearance and odour of vaginal secretions), microbiologic and microscopic analysis of vaginal secretions to identify pathogens, to assess the intensity of the inflammatory reaction (by polymorphonuclear cell density), and the density of the lactobacilli flora. The results showed that the vaginal administration of the prebiotic complex, xylitol and dispareunie, disurie, edem, eritem, aspectul și mirosul secrețiilor vaginale), analiza microbiologică și analiza microscopică a secrețiilor vaginale pentru identificarea patogenilor, evaluarea intensității reacției inflamatorii (prin densitatea celulelor polimorfonucleate), evaluarea densității florei de lactobacili. Rezultatele au arătat că prin administrarea vaginală a complexului de prebiotice se controlează eficient simptomatologia și încărcarea microbiană patogenă și, în plus față de tratamentul clasic cu antibiotic și/sau antifungic, se reface flora sănătoasă de lactobacili și astfel împiedică dezvoltarea oportunistă de Candida.