San PIO X Hospital, Italy
Dr. Franco Vicariotto, Medicine Doctor (Ph.D. Medicine), is a specialist in Obstetrics and Gynecology and is now senior consultant of San PIO X Hospital of Milan. He has been deputy head of division of Ob/Gyn. of Niguarda Hospital of Milan for almost 20 years where he had conducted important researches in the field of Infectious Diseases in Obstetrics and Gynecology. He is one of the founders and vice-president of the scientific society Esidog Italia (European Society for Infectious Diseases in Obstetrics and Gynaecology) and the member of the National board of S.I.C. (Italian society of Contraception). He is author of many publications and recognized moderator-spokesman in specialized conferences in Italy and abroad.
Vulvovaginal candidiasis (VVC) is the second most common cause of vaginitis after bacterial vaginosis, and it is diagnosed in up to 40% of women with vaginal complaints in the primary care setting. Among Candida spp., Candida albicans is the most common infectious agent. The treatment of choice for uncomplicated VVC is achieved with single-dose or short-course therapy in over 90% of cases. Several topical and oral drugs are available, without evidence for superiority of any agent or route of administration. In any case, most classic treatments are unable to significantly offer a protection against possible recurrences. In recent years, probiotics are emerging as a new strategy to counteract VVC. In fact, they are well known for their ability to lower intravaginal pH, thus establishing a barrier effect against many types of yeasts. Some strains are also able to exert additional and more focused antagonistic activities mediated by specific molecules such as hydrogen peroxide and bacteriocins. For example, Lactobacillus fermentum LF5 (CNCM I-789) was successfully tested in 4 human trials involving a total of 340 women reporting VVC at enrollment. In any case, the way used to deliver probiotics to the vaginal environment represents a crucial point. The aim of this work was to first select 1 or more probiotic strains in vitro with an antagonistic activity on Candida yeasts and then to perform an in vivo human pilot study using an association of the most promising and active bacteria.