{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T18:10:46Z","timestamp":1792519846515,"version":"4.5.0"},"reference-count":53,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2019,8,8]],"date-time":"2019-08-08T00:00:00Z","timestamp":1565222400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2020,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Vaginal probiotics claiming to cure and\/or prevent bacterial and\/or fungal vaginal dysbiosis are available on the market but, until recently, did not have to be approved as drugs for human use.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>\n                      We evaluated the impact of vaginal probiotics on bacterial vaginosis (\n                      <jats:styled-content style=\"fixed-case\">BV<\/jats:styled-content>\n                      ) and vulvovaginal candidiasis (\n                      <jats:styled-content style=\"fixed-case\">VVC<\/jats:styled-content>\n                      ) cure and\/or recurrence, as well as vaginal microbiota (\n                      <jats:styled-content style=\"fixed-case\">VMB<\/jats:styled-content>\n                      ) composition and vaginal detection of probiotic strains.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Search strategy<\/jats:title>\n                    <jats:p>\n                      We performed a systematic literature search in\n                      <jats:styled-content style=\"fixed-case\">MEDLINE<\/jats:styled-content>\n                      and Embase up to 15 January 2019.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Selection criteria<\/jats:title>\n                    <jats:p>\n                      There were no restrictions in probiotic strains\/formulations, study populations, and designs.\n                      <jats:styled-content style=\"fixed-case\">BV<\/jats:styled-content>\n                      had to be diagnosed by Nugent or Ison\u2010Hay Gram stain scoring,\n                      <jats:styled-content style=\"fixed-case\">VVC<\/jats:styled-content>\n                      by culture, wet mount or\n                      <jats:styled-content style=\"fixed-case\">PCR<\/jats:styled-content>\n                      , and\n                      <jats:styled-content style=\"fixed-case\">VMB<\/jats:styled-content>\n                      composition\/detection by molecular techniques.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data collection and analysis<\/jats:title>\n                    <jats:p>The authors independently extracted data.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main results<\/jats:title>\n                    <jats:p>\n                      All 22 vaginal probiotics evaluated in the 34 eligible studies contained\n                      <jats:italic>Lactobacillus<\/jats:italic>\n                      strains, and some contained additional active ingredients. The probiotics hold promise for\n                      <jats:styled-content style=\"fixed-case\">BV<\/jats:styled-content>\n                      cure and prevention, but much less so for\n                      <jats:styled-content style=\"fixed-case\">VVC<\/jats:styled-content>\n                      cure and prevention. No major safety concerns were reported in any of the studies. Vaginal detection of probiotic strains never lasted long beyond the dosing period, suggesting that they did not colonise the vagina. However, findings are not definitive because heterogeneity was high and the quality of most studies suboptimal.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Availability of vaginal probiotics for vaginal health indications will likely decline in 2020 because of regulatory changes. We urge the field to invest in clinical evidence\u2010based product development and to conduct future trials more rigorously.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Tweetable abstract<\/jats:title>\n                    <jats:p>Lactobacilli\u2010containing vaginal probiotics hold promise for bacterial vaginosis cure and prevention, but not for vulvovaginal candidiasis.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/1471-0528.15870","type":"journal-article","created":{"date-parts":[[2019,7,12]],"date-time":"2019-07-12T14:19:03Z","timestamp":1562941143000},"page":"287-299","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":146,"title":["Lactobacilli\u2010containing vaginal probiotics to cure or prevent bacterial or fungal vaginal dysbiosis: a systematic review and recommendations for future trial designs"],"prefix":"10.1111","volume":"127","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2728-4560","authenticated-orcid":false,"given":"JHHM","family":"van de Wijgert","sequence":"first","affiliation":[{"name":"Institute of Infection and Global Health University of Liverpool Liverpool UK"},{"name":"Julius Center for Health Sciences and Primary Care University Medical Center Utrecht Utrecht University Utrecht the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"MC","family":"Verwijs","sequence":"additional","affiliation":[{"name":"Institute of Infection and Global Health University of Liverpool Liverpool UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,8,8]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0105998"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.resmic.2017.02.003"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.resmic.2017.04.001"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/civ353"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1002478"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1038\/nmicrobiol.2017.57"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12879-015-1027-4"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0161337"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-019-39625-0"},{"key":"e_1_2_6_11_1","article-title":"Intermittent lactobacilli-containing vaginal probiotic or oral metronidazole use to prevent bacterial vaginosis recurrence: safety and preliminary efficacy by microscopy and sequencing","author":"Wijgert JHHM","year":"2019","journal-title":"MedRxiv"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1000097"},{"key":"e_1_2_6_13_1","unstructured":"Prospero\u2014International prospective register of systematic reviews [Internet]. 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