Lactobacillus strains and vaginal ecology 
Nutrition in clinical care : an official publication of Tufts University
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Bacterial vaginosis, urinary tract infection, and yeast vaginitis afflict an estimated 1 billion women each year. Once investigation has ruled out complicated underlying causes, the only therapeutic option is antimicrobial agents. In many cases, this is effective at clearing infection. However, recurrences, side effects, and secondary infections are frequent. Coinciding with infection is a disruption of the normal commensal microflora in the vagina, primarily a loss of lactobacilli. The exogenous application of lactobacilli to the host as probiotic agents appears to offer hope as an alternative management regimen to antimicrobial treatment and prophylaxis. Although commercial probiotics specifically selected and proven to be effective for urogenital infections are not yet available, there is growing in vitro and human data to suggest that certain strains could confer health benefits on a large number of women. Given that depleted vaginal lactobacilli and recurrent infection is associated with increased risk of sexually transmitted diseases and preterm labor, multiple antibiotic resistance, and significant reduction in quality of life, the need for probiotic therapeutics has never been greater.