Recurrent infections: Looking beyond antibiotics and antifungals

About 45% of women in the reproductive age group suffer from vaginal infections at least once in their lifetime. For many it is recurrent and irritating. Just offering antibiotics and antifungals do not suffice and the women come back repeatedly to us with itchiness, profuse vaginal discharge, and irritation.

 Today I saw a patient who has been suffering from frequent recurrent attacks in the last one year to the extent that her skin in the perineum is full of scratch marks as a result of intense itchiness. She has been tried with repeated courses of antifungals and antibiotics but with no positive results.

These cases should be reviewed differently. Blood sugar and other co infections should be checked by serology.  Probiotics have a definite role to play here.

The female vagina harbors several anaerobic and aerobic microorganisms which play a crucial role in the maintenance of health and prevention of infection.  The normal vaginal microflora comprises of over 50 microbial species generally dominated by Lactobacillus, most common of which are L. rhamnosus, L.reuteri, followed by L. acidophilus, L. fermentum, L. plantarum, L. brevis, L. casei, L. vaginalis, L. gasseri, and L.jensenii

This normal colonization of the vagina or the normal vaginal flora is often disturbed with antibiotics thus giving the pathogenic organisms a chance to gain foothold. Therefore treating these women with probiotics help in restoring the same.  The World Health Organization (WHO) defines probiotics as ‘live microorganisms which when administered in adequate amounts confer a health benefit on the host.’ Probiotic supplements are live microbial supplements which offer beneficial effects to the host by improving or restoring microbial balance.

These are available as capsules, tablets, liquids and are very convenient to be used. Choosing the right probiotic is the crucial decision in treating these women.