Modern treatment tactics and prophylaxis of bacterial vaginosis

Bacterial vaginosis (BV) represents one of the most prevalent causes of abnormal vaginal discharge with an unpleasant odor among women of reproductive age. This condition is characterized by a disruption in the vaginal microbiome, with a decline in lactobacilli dominance and an increased presence of diverse facultative and obligate anaerobic bacteria. BV has been associated with an elevated risk of adverse health outcomes, including preterm birth, ectopic pregnancy, and susceptibility to sexually transmitted infections. While the current standard of care involves the use of antibiotics, these therapies, although effective in the short term, frequently fail to address high recurrence rates. A new direction in gynecology has become the transplantation of the vaginal microbiota (TMV), which can also be considered in other conditions associated with a violation of its composition. Currently, there is an opinion that the use of lactic acid can serve as a real alternative to antibiotics and probiotics This review aims to explore the contemporary landscape of research on non-antibiotic therapeutic approaches for BV, focusing on recent data concerning the effectiveness of alternative options such as combinations of lactic acid and glycogen, probiotics with lactobacilli, and combination treatments incorporating estriol. KEYWORDS: bacterial vaginosis, treatment, clindamycin, metronidazole, probiotics, prebiotics, lactic acid, glycogen. FOR CITATION: Kazantseva V.D., Ozolinya L.A., Savchenko T.N., Dobrokhotova Yu.E. Modern treatment tactics and prophylaxis of bacterial vaginosis. Russian Journal of Woman and Child Health. 2025;8(1):27–31 (in Russ.). DOI: 10.32364/2618-8430-2025-8-1-4