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

PETRU CHITULEA, RAREȘ GHERAI, CRISTIAN CHETA *, TANIA MARIN NEGRU

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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-glycooligosaccharides 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 hyaluronic acid effectively controls the symptoms and pathogenic microbial load and, in unlike to the classic antibiotic and/or antifungal treatment, restores the healthy flora of lactobacilli and thus prevents the opportunistic development of Candida.