Initial cure of BV infection makes live biotherapeutics more effective

Bacterial vaginosis (BV), a genital tract infection, is linked to an elevated risk of negative outcomes such as preterm birth and acquiring sexually transmitted infections, including HIV. For decades, the only treatment for BV has been antibiotics, but it’s common for the infection to return.

Clinical research has explored the use of live biotherapeutic products after antibiotics to help the vagina replenish naturally occurring Lactobacillus bacteria strains.

Previous research from Bixby members Craig Cohen, MD, and Anke Hemmerling, MD, and colleagues has shown that LACTIN-V, a live biotherapeutic, helped reduce the recurrence of BV infections. However, they found that 30% of people who received LACTIN-V had an infection return by 24 weeks after treatment, a higher-than-expected rate. The research team wanted to determine if this outcome was linked to the infection not being cured by the initial round of antibiotics.

In a new paper, they found that most women in the study achieved a clinical cure of their BV infections within 7 days of the initial antibiotic treatment. More than half of the women who received a placebo after initial treatment instead of LACTIN-V experienced a recurrence by 24 weeks, confirming the limited effect of antibiotic regimes alone.

Women whose infections were not cured in the initial round of antibiotics had a higher rate of recurrent BV. This analysis found that the clinical cure of BV after antibiotic treatment is crucial to laying the groundwork for colonization of the Lactobacillus bacteria, leading to low rates of BV recurrence and maximizing the benefits of LACTIN-V.

These results indicate that clearing BV-associated microbes before giving live biotherapeutic products may be crucial to maximizing their effectiveness, thus helping to prevent the negative reproductive health outcomes that come with recurring BV.