Trial reportBMJ (Clinical research ed.)2004
Effect of lactobacillus in preventing post-antibiotic vulvovaginal candidiasis: a randomised controlled trial.
Trial report in BMJ (Clinical research ed.), 2004. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers, 4 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
26 citing papers in PubMed, 4 syntheses or guidelines pooled it, 134 citations in OpenAlex.
- The Role of Probiotics in the Treatment of Vulvovaginal Candidiasis: A Systematic Review and Meta-Analysis.Ethiopian journal of health sciences · 2023Pooled it
- Treatment for recurrent vulvovaginal candidiasis (thrush).The Cochrane database of systematic reviews · 2022Pooled it
- Guideline
- Probiotics for vulvovaginal candidiasis in non-pregnant women.The Cochrane database of systematic reviews · 2017Pooled it
- Local Probiotic Therapy for Vaginal Candida albicans Infections.Probiotics and antimicrobial proteins · 2015Trial
- Does eating yogurt prevent antibiotic-associated diarrhoea? A placebo-controlled randomised controlled trial in general practice.The British journal of general practice : the journal of the Royal College of General Practitioners · 2007Trial
- Isolation of non-albicans Candida and associated factors among symptomatic women presenting with abnormal vaginal discharge at Mubende Regional Referral Hospital, Central Uganda: A cross-sectional study.PLOS global public health · 2026Article
- Probiotics in the Management of Vulvovaginal Candidosis.Journal of clinical medicine · 2024Review
- Candidiasis in Pregnancy: Relevant Aspects of the Pathology for the Mother and the Fetus and Therapeutic Strategies.Tropical medicine and infectious disease · 2024Review
- A probiotic nanozyme hydrogel regulates vaginal microenvironment forScience advances · 2023Article
- Impacts of Menstruation, Community Type, and an Oral Yeast Probiotic on the Vaginal Microbiome.mSphere · 2022Article
- Comparison between the Efficacy ofEvidence-based complementary and alternative medicine : eCAM · 2022Article
- Vaginal and oral use of probiotics as adjunctive therapy to fluconazole in patients with vulvovaginal candidiasis: A clinical trial on Iranian women.Current medical mycology · 2021Article
- Evaluation of the Inhibitory Effects ofFrontiers in medicine · 2020Article
- Vulvovaginitis Caused by Candida Species Following Antibiotic Exposure.Current infectious disease reports · 2019Review
- Inhibition of Candida albicans morphogenesis by chitinase from Lactobacillus rhamnosus GG.Scientific reports · 2019Article
- Interplay between Lactobacillus rhamnosus GG and Candida and the involvement of exopolysaccharides.Microbial biotechnology · 2017Article
- Is it possible to prevent recurrent vulvovaginitis? The role of Lactobacillus plantarum I1001 (CECT7504).European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2016Article
- Vulvovaginal Candidosis (excluding chronic mucocutaneous candidosis). Guideline of the German Society of Gynecology and Obstetrics (AWMF Registry No. 015/072, S2k Level, December 2013).Geburtshilfe und Frauenheilkunde · 2015Article
- Epidemiologic features of Vulvovaginal Candidiasis among reproductive-age women in India.Infectious diseases in obstetrics and gynecology · 2012Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo test whether oral or vaginal lactobacillus can prevent vulvovaginitis after antibiotic treatment.
designRandomised, placebo controlled, double blind, factorial 2x2 trial.
settingFifty general practices and 16 pharmacies in Melbourne, Australia.
participantsNon-pregnant women aged 18-50 years who required a short course of oral antibiotics for a non-gynaecological infection: 278 were enrolled in the study, and results were available for 235.
interventionsLactobacillus preparations taken orally or vaginally, or both, from enrollment until four days after completion of their antibiotic course.
main outcome measuresParticipants' reports of symptoms of post-antibiotic vulvovaginitis, with microbiological evidence of candidiasis provided by a self obtained vaginal swab.
resultsOverall, 55/235 (23% (95% confidence interval 18% to 29%)) women developed post-antibiotic vulvovaginitis. Compared with placebo, the odds ratio for developing post-antibiotic vulvovaginitis with oral lactobacillus was 1.06 (95% confidence interval 0.58 to 1.94) and with vaginal lactobacillus 1.38 (0.75 to 2.54). Compliance with antibiotics and interventions was high. The trial was terminated after the second interim analysis because of lack of effect of the interventions. Given the data at this time, the chances of detecting a significant reduction in vulvovaginitis with oral or vaginal lactobacillus treatment were less than 0.032 and 0.0006 respectively if the trial proceeded to full enrollment.
conclusionsThe use of oral or vaginal forms of lactobacillus to prevent post-antibiotic vulvovaginitis is not supported by these results. Further research on this subject is unlikely to be fruitful, unless new understandings about the pathogenesis of post-antibiotic vulvovaginitis indicate a possible role for lactobacillus.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.