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Probiotics, especially direct vaginal sprays, offer a promising alternative to antibiotics by restoring healthy vaginal microbiota, relieving symptoms, and preventing recurrence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We conducted a clinical trial (ClinicalTrials.gov: NCT06165354; 8\/12\/2023) to evaluate the effectiveness of the vaginal-spray probiotic LiveSpo X-Secret, containing\n                      <jats:italic>Bacillus subtilis<\/jats:italic>\n                      ,\n                      <jats:italic>B. clausii<\/jats:italic>\n                      , and\n                      <jats:italic>B. coagulans<\/jats:italic>\n                      spores (\u22651 billion CFU\/mL). A total of 120 women were randomized equally into Control and X-Secret groups at Bac Ninh CDC. Outcomes were assessed at day 7 (end of standard treatment) for symptom resolution and day 28 (21 days post-treatment) for recurrence. Both Per-Protocol and Intention-to-Treat analyses were performed to assess efficacy and account for attrition.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Here we show that no adverse events occur in either group. Compared to the Control, the X-Secret group exhibits a faster reduction in BV symptoms (odor, discharge, pH &gt;4.5, and itching) by days 7 and 28, with odds ratios at day 28 of 3.61, 4.87, 2.95, and 3.34, respectively. Vaginal swab analysis reveals a 3.7\u2013225.3-fold greater reduction in\n                      <jats:italic>Gardnerella vaginalis<\/jats:italic>\n                      . By day 28, metagenomic profiling indicates increases in beneficial species\n                      <jats:italic>Lactobacillus crispatus<\/jats:italic>\n                      (3.71-fold) and\n                      <jats:italic>Streptococcus salivarius<\/jats:italic>\n                      (from non-detectable to 2.1%), along with reductions in harmful species\n                      <jats:italic>G. vaginalis<\/jats:italic>\n                      (14.29-fold) and\n                      <jats:italic>Sneathia sanguinegens<\/jats:italic>\n                      (806-fold).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      The vaginal-spray\n                      <jats:italic>Bacillus<\/jats:italic>\n                      spore probiotic (LiveSpo X-Secret) provides a safe, convenient, and effective approach for BV treatment and reducing recurrence, supporting its potential as an adjunctive therapy for maintaining vaginal health.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical trial number<\/jats:title>\n                    <jats:p>ClinicalTrials.gov NCT06165354, first posted 8\/12\/2023.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1038\/s43856-025-01236-4","type":"journal-article","created":{"date-parts":[[2025,11,18]],"date-time":"2025-11-18T05:37:31Z","timestamp":1763444251000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Vaginal-spray Bacillus spore probiotics as a potential treatment and reducing recurrence of bacterial vaginosis: randomized, double-blind, and controlled pilot study"],"prefix":"10.1038","volume":"5","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6714-068X","authenticated-orcid":false,"given":"Huyen Thi","family":"Bui","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anh Thi Phuong","family":"Bui","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hong Thi","family":"Ngo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xuan Thi","family":"Ngo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huyen Thi","family":"Nguyen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anh Hoa","family":"Nguyen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Van Cam","family":"Tran","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tung Dinh","family":"Pham","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1215-6910","authenticated-orcid":false,"given":"Anh Thi Van","family":"Nguyen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,11,18]]},"reference":[{"key":"1236_CR1","doi-asserted-by":"publisher","first-page":"304","DOI":"10.1097\/OLQ.0000000000000972","volume":"46","author":"K Peebles","year":"2019","unstructured":"Peebles, K., Velloza, J., Balkus, J. 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A.T.V.N. serves as a Scientific Consultant for LiveSpo Pharma. A.T.V.N., A.T.V.N., H.T.B., and A.T.P.B. are employees of ANABIO R&D Ltd., which funded this study; as part of their employment, they contributed to study design, data analysis, and manuscript preparation. A.H.N. and H.T.N. work for LiveSpo Pharma Ltd.; however, they had no role in study design, data collection or analysis, the decision to publish, or manuscript preparation. The remaining authors report no conflicts of interest.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"527"}}