
Tsubanova Nataliya
Andrei Krupynskyi Lviv Medical Academy, UkrainePresentation Title:
Probiotic Combinations for women. Effectiveness and safety from the points of evidence-based medicine
Abstract
To date, probiotic medicinal products have a significant number of clinical studies, which is the basis for the formation of an evidence base and their inclusion in modern treatment standards. However, ideas about the optimal composition of a probiotic preparation and effective dosage remain problematic issues in modern medicine. Choosing an effective probiotic in gynecological practice is a particularly difficult and important issue. And if for a single-component probiotic product, it is clear how to check the reliability of clinical evidence, then multi-component probiotic products remain problematic from the point of view of evidence-based medicine. We propose to review the presence/absence of reliable evidence for each component of probiotic combination products.
Objective of the review: To analyze the available clinical studies aimed at identifying strains of beneficial bacteria, their dosage, possible combinations in order to choose the optimal composition of a probiotic agent for the treatment of dysbiosis, including vaginal. Analysis of the clinical evidence base for combined probiotics.
Materials and methods: Modern methods recommended for theoretical analytical research were used: method of analysis, method of synthesis, method of induction. An electronic search was conducted in bibliographic databases, including PubMed, CENTRAL, MEDLINE, Embase, and CINAHL. 58 scientific publications were analyzed. Inclusion criteria were the following keywords: probiotics, optimal dosage, optimal composition, dysbiosis.
Results: The most important probiotic microorganisms for restoring health in women are Lactobacillus acidophilus, L. crispatus, L. jensenii, L. gasseri, L. rhamnosus. Each of these lactobacilli maintains the normal vaginal pH, produces hydrogen peroxide, suppresses growth and prevents the reproduction of obligate anaerobes and opportunistic microorganisms when interacting with the peroxidase of cervical mucus. The mechanism of action of the above-mentioned probiotic microorganisms was analyzed. It was established that the effective dose of each of the components should not be less than 1-2 billion colony forming units.
Conclusions: The analysis of scientific publications in the bibliographic databases was sufficient to establish that the oral use of probiotics in the treatment of gynecological patients is effective. The optimal components of the probiotic agent, which are effective for the therapy of vaginal dysbiosis, are L. crispatus, L. gasseri, L. jensenii, L. rhamnosus, L. acidophilus. Keywords: probiotic agent, vaginal dysbiosis, Lactobacillus crispatus, Lactobacillus gasseri, Lactobacillus jensenii, Lactobacillus rhamnosus, Lactobacillus acidophilus.
Biography
Tsubanova Natalia graduated from the Faculty of Pharmacy of the Ukrainian Pharmaceutical Academy, earning a master's degree in "Pharmacology" (1998) and completing postgraduate studies in 2003. In 2020, she also obtained a master's degree in "Higher School Pedagogy." Since 1996, she has been working at the National University of Pharmacy, starting as a senior laboratory assistant (1996) of the Department of Clinical Pharmacy, and later serving as a junior research fellow (1998) of the Central Research Laboratory. From 2005 to 2009, she held the position of associate professor of the Department of Pharmacotherapy, and subsequently as an associate professor (2009) and professor (2014–2019) of the Department of General Pharmacy and Drug Safety of the Institute of Clinical Pharmacy of the National University of Pharmacy. Since 2019, she has been a professor of the Department of Clinical Pharmacology of the Institute of Clinical Pharmacy of the National University of Pharmacy. Since August 2022, she has been a professor of the Department of Pharmacy of the A. Krupynskyi Lviv Medical Academy. Her field of scientific research includes preclinical pharmacological studies of biologically active substances with organoprotective effects (phleboprotective, psychotropic, nephroprotective, cardioprotective, hepatoprotective), clinical studies, and evidence-based medicine and pharmacy. She is the author and co-author of over 380 scientific publications. She also serves as a reviewer of foreign scientific publications indexed in the SCOPUS bibliographic database.