ABSTRACT
Objective: To demonstrate that vaginal application of boric acid and probiotics is effective for the treatment of vulvovaginitis and can be considered not only an alternative option, but also a first-line treatment.Material and methods: We performed a multicenter, open-label, pilot trial with random allocation to the study treatment (150 mg boric acid + Lactobacillus gasseri and Lactobacillus rhamnosus) or active control treatment (clotrimazole in candida vulvovaginitis and clindamycin in bacterial vulvovaginitis). All treatments were administered vaginally. The study population comprised 48 women aged >18 years with a suspected diagnosis of vulvovaginitis. We excluded patients who were menstruating or breastfeeding and patients who were pregnant (or planning to become pregnant) at baseline. We also excluded patients who had taken antibiotic treatment or probiotic prophylaxis in the previous 2 weeks and treatments that could interfere with the study. Similarly, we excluded patients infected by Chlamydia trachomatis, Trichomonas vaginalis, Neisseria gonorrhoeae, or Herpes simplex. Follow-up lasted 12 weeks and included 3 face-to-face contacts and 2 telephone calls. Results: Almost all patients (97.9%) were of childbearing age, 100% were sexually active, 77.1% had a history of vulvovaginitis, and 41.7% had recurrent vulvovaginitis. After treatment, the cure rate was 60.9% in the study treatment group and 62.5% in the control group. Vulvovaginitis improved in 39.1% and 33.3%, respectively, and no response was observed in 0% and 4.2% respectively, with no significant differences between the treatments. The Sobel score improved significantly (p<0.05) after 2 weeks of follow-up (study treatment, baseline=5.83±1.6 and 2 weeks=1.00±1.90; control treatment, baseline=6.13±3.03 and 2 weeks=1.30±2.72), although there were no significant differences between the groups. Conclusions: Administration of boric acid and probiotics for treatment of vulvovaginitis proved to be as effective as the standard treatment for candida and bacterial vulvovaginitis. Larger studies are needed to confirm our findings
Objetivo: Demostrar que la administración vaginal de ácido bórico y probióticos en vulvovaginitis oportunistas es un tratamiento eficaz, no solo como opción alternativa, sino también como primera opción terapéutica. Material y métodos: Ensayo piloto multicéntrico, abierto, con asignación aleatoria al tratamiento en estudio (150mg ácido bórico + L.gasseri y L.rhamnosus, AB+P) o al control (C) activo (clotrimazol en vulvovaginitis candidiásica y clindamicina en vulvovaginitis bacteriana), todos vía vaginal. Se incluyó 48 mujeres > 18 años, con diagnóstico de sospecha de vulvovaginitis. Se excluyó pacientes con menstruación, con lactancia, embarazadas (o susceptibles de embarazo) al inicio del estudio, con tratamiento antibiótico o profilaxis con probióticos en las 2 semanas previas y tratamientos que pudieran interferir. Se excluyó pacientes con infección por Chlamydia trachomatis, Trichomona vaginalis, Neisseria gonorrhoeae o Herpes simplex. Se siguieron 12 semanas con 3 controles presenciales y 2 telefónicos. Resultados: 97,9% estaban en edad fértil, 100% eran sexualmente activas, 77,1% tenía antecedentes de vulvovaginitis y 41,7% sufría vulvovaginitis recurrentes. Tras el tratamiento, se logró resolución en un 60,9% con AB+P y un 62,5% con C, mejoría en 39,1% y 33,3% y ausencia de respuesta en 0% y 4,2% respectivamente, sin diferencias significativas entre tratamientos. Sobel score mostró mejoría significativa (p<0,05) tras 2 semanas de seguimiento (AB+P: basal=5,83±1,6 y 2sems=1,00±1,90, C: basal=6,13±3,03 y 2sems=1,30±2,72) sin diferencias entre grupos. Conclusiones: El tratamiento de vulvovaginitis con ácido bórico y probióticos resultó un recurso terapéutico igual de eficaz que los tratamientos estándar para vulvovaginitis candidiásica y bacteriana. Estudios más amplios podrían confirmarlo
