Meta AnalysisID 4007
乳酸治疗细菌性阴道病及其对阴道微生物群影响的系统评价
CRD42018115982
There are two review questions: 1. What is effect of lactic acid treatments on bacterial vaginosis cure? 2. How do lactic acid treatments influence the vaginal microbiota in women with and without BV (as measured by mole
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Record Fields
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- Meta Analysis Id
- 4007
- Evidence Id
- 12565
- Core Evidence Id
- 12565
- Source Meta Analysis Id
- 3963
- Herb2 Meta Analysis Id
- HBMA003963
- Crd Id
- CRD42018115982
- Title
- Lactic acid for the treatment of bacterial vaginosis and the impact of lactic acid treatments on the vaginal microbiota: a systematic review
- Review Question
- There are two review questions: 1. What is effect of lactic acid treatments on bacterial vaginosis cure? 2. How do lactic acid treatments influence the vaginal microbiota in women with and without BV (as measured by molecular methods [including but not limited to polymerase chain reaction (PCR), quantitative (q)PCR, high throughput sequencing])?
- Study Type Included
- Published studies that report an intravaginal lactic acid containing treatment and a BV and/or microbiota outcome will be included. For studies with a BV outcome (Aim 1), the study must be a randomised controlled trial and BV must be measured by an accepted diagnostic method e.g. Amsel criteria, modified Amsel criteria or Nugent method. For studies with a microbiota outcome (Aim 2), any study design is permissible (observational studies including cross-sectional studies, cohorts, early phase clinical trials, and randomised controlled trials are all eligible) and the microbiota must be measured by molecular methods (including but not limited to polymerase chain reaction (PCR), quantitative (q)PCR, high throughput sequencing). Any identified and relevant published conference abstracts will be included. There will be no restrictions on year of publication; however articles in a language other than English will be excluded.
- Condition Being Studied
- Bacterial vaginosis (BV) is the most common vaginal condition of reproductive aged women. The healthy vagina is typically colonised with lactic acid producing bacteria (particularly Lactobacillus spp.). Conversely, BV is characterised by a decrease in beneficial Lactobacillus (and subsequently a decrease in lactic acid) and an increase in the abundance and diversity of anaerobic bacteria collectively known as BV-associated bacteria. Current treatments for BV are sub-optimal with more than 50% of women getting their BV back within 6-12 months after standard antibiotic therapy. New and innovative treatments for BV are desperately needed. There is increasing interest in the use of lactic acid to treat BV because of its antimicrobial, antiviral and immunomodulatory properties. We aim to investigate the efficacy of lactic acid treatments (which can take the form of any intravaginal formulation that contains lactic acid) for BV cure and the impact of lactic acid treatments on the vaginal microbiota.
- Participant
- Inclusion criteria for Aim 1 (BV endpoint): • Women with BV of any age • Use of an established diagnostic method for BV (e.g. Nugent score, Amsel criteria, modified Amsel criteria) • Use of an intravaginal lactic acid formulation as the main or adjuvant therapy for BV treatment Exclusion criteria for Aim 1(BV endpoint): • Non-randomised studies • Studies where data is not stratified by on/off lactic acid therapy. • Studies where details of combination therapy are not provided • Women who are pregnant • Women who are post-menopausal Inclusion criteria for Aim 2 (microbiota endpoint): • Women with or without BV of any age • Women receiving an intravaginal lactic acid formulation • Reports a measure of vaginal microbiota composition by molecular methods (including but not limited to polymerase chain reaction (PCR), quantitative (q)PCR, high throughput sequencing) Exclusion criteria for Aim 2: • Studies where data is not stratified by on/off lactic acid therapy. • Studies where details of combination therapy are not provided • Women who are pregnant • Women who are post-menopausal
- Animal
- Human Disease Modelled
- Intervention
- The intervention is treatment with an intravaginal lactic acid containing formulation. The lactic acid formulation can be used as the main or adjuvant therapy for BV. There is no restriction on the formulation other than it must be contain lactic acid and be an intravaginal product. Studies examining probiotic formulations that contain lactic acid producing bacteria will be excluded.
- Comparator Control
- Controls for Aim 1 (BV outcome) will be women who did not use lactic acid. Controls may be receiving no treatment, placebo or a standard treatment for BV (i.e. metronidazole or clindamycin). Controls are not required for Aim 2 (microbiota endpoint), but where available will be women who did not use LA or the baseline sample could act as a control if it is collected pre-lactic acid treatment
- Main Outcome
- 1. BV outcome: proportion of women with BV cured (i.e. <3 Amsel’s Criteria and/or Nugent Score<4) post-therapy with 95% CI 2. Microbiota outcome: vaginal microbiota composition as measured by molecular methods Measures of effect Not applicable
- Outcome Measure
- Additional Outcome
- Adverse events Measures of effect Not applicable
- Study Method
- Systematic review
- Keyword
- Female; Humans; Lactic Acid; Microbiota; Vaginosis, Bacterial
- Contact
- Erica Plummer [email protected]
- Organisational Affiliation
- Monash University
- Funding Source
- Other Selection Criteria
- Final Publication
- Same Topic Review
- Published Protocol
- Review Type
- Language
- English
- Country
- Australia
- Review Stage
- Review Completed not published
- First Submission Date
- 2018-11-06
- Registration Date
- 2018-11-26
- Anticipated Start Date
- 2018-10-28
- Anticipated Completion Date
- 2020-10-28
- Title Cn
- 乳酸治疗细菌性阴道病及其对阴道微生物群影响的系统评价
- Title En
- Lactic acid for the treatment of bacterial vaginosis and the impact of lactic acid treatments on the vaginal microbiota: a systematic review
- Bilingual Status
- complete