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Moderate evidenceWomen's health

Lactobacillus Crispatus

The species that dominates a healthy vaginal microbiome. A specific live-biotherapeutic strain reduces bacterial vaginosis recurrence after antibiotics, which is not the same as any capsule labelled L. crispatus working.

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What the science says

  • Preventing bacterial vaginosis recurrence Moderate evidence

    A randomized trial of vaginally applied L. crispatus CTV-05 (Lactin-V) after antibiotic treatment found recurrence in about 30 percent of the treated group versus 45 percent on placebo at 12 weeks. This is a single well-conducted trial of a specific investigational product.

  • Benefit depends on clearing the infection first Limited evidence

    A secondary analysis of that trial found the strain's effectiveness was concentrated in women whose bacterial vaginosis had actually responded to the preceding antibiotic course. It appears to work as maintenance, not as a treatment on its own.

Dosage & safety

Studied doseThe studied product is a vaginal applicator of live L. crispatus CTV-05, used daily for four days then twice weekly for ten weeks after antibiotics. Oral and vaginal retail capsules use different, unstudied strains at doses of roughly 1-10 billion CFU.
SafetyWell tolerated in trials, with vaginal discharge and itching the main reports and no excess of serious events. Live biotherapeutics have not been studied in pregnancy or in immunocompromised women. A retail product is not interchangeable with the trial strain.

How to take it

TimingVaginal products are used at bedtime so they stay in place overnight.
With food?Oral capsules can be taken with or without food.
Worth knowingRecurrent symptoms need a diagnosis first — bacterial vaginosis, thrush and trichomonas look similar and are treated completely differently.

Interactions

With medications

  • antibiotics

    Antibiotics kill the supplied organisms. start after the antibiotic course, as in the trial, or separate oral doses by at least 2 hours

  • immunosuppressants

    Live organisms carry a small risk of invasive infection when immunity is suppressed. do not use without medical supervision

Well-established interactions only — this is not a complete list. Always tell your doctor and pharmacist what you take.

Frequently asked questions

Does Lactobacillus crispatus prevent bacterial vaginosis?

A specific strain does: in a randomized trial, vaginal L. crispatus CTV-05 (Lactin-V) after antibiotics cut bacterial vaginosis recurrence to about 30 percent versus 45 percent on placebo at 12 weeks, a moderate-grade result. That does not mean any capsule labelled L. crispatus works.

Can Lactobacillus crispatus treat BV on its own?

No: the benefit of L. crispatus was concentrated in women whose bacterial vaginosis had already responded to antibiotics, so it works as maintenance rather than treatment. Start it after the antibiotic course, as in the trial.

Do oral Lactobacillus crispatus capsules work?

Oral and vaginal retail L. crispatus capsules use different, unstudied strains at roughly 1-10 billion CFU, so the trial result does not transfer to them. The studied product was a vaginal applicator used daily for four days, then twice weekly for ten weeks.

Is Lactobacillus crispatus safe?

L. crispatus was well tolerated in trials, with vaginal discharge and itching the main complaints. It has not been studied in pregnancy or in immunocompromised women, and should not be used with immunosuppressants without medical supervision.

Scientific references

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