Table 1 Role of probiotics in International guidelines for the treatment of vulvovaginal infections

European (IUSTI/WHO) guideline, 2011 [39]

Potential role of vaginal probiotics in the management of recurrent BV

Faculty of Sexual & Reproductive Healthcare, Royal College of Obstetricians and Gynaecologists (RCOG), 2012 [40]

Recurrent BV:

There is currently insufficient evidence to recommend the use of probiotics either before, during or after antibiotic treatment as a means of reducing recurrence.

Recurrent VVC:

Non-conventional management regimens such as dietary changes, use of probiotics, tea tree oil and not wearing tight clothing have been studied. There is currently insufficient evidence to support their recommendation in treatment.

German Society for Gynecology and Obstetrics, 2015 [41]

Probiotics have shown encouraging, but controversial results and require further investigation

Society of Obstetrician and Gynaecologyst of Canada (SOGC), 2015 [42]

Current evidence of the efficacy of alternative therapies for bacterial vaginosis (probiotics, vitamin C) is limited (I).

Centers for Disease Control and Prevention (CDC), 2015 [43]

Overall, no studies support the addition of any available lactobacillus formulations or probiotic as an adjunctive or replacement therapy in women with BV. Further research efforts to determine the role of these regimens in BV treatment and prevention are ongoing