Antibiofilm agents for the treatment and prevention of bacterial vaginosis: a systematic narrative review

Michael Gao, Jim Manos, Greg Whiteley, Iryna Zablotska-Manos

    Research output: Contribution to journalArticlepeer-review

    4 Citations (Scopus)
    16 Downloads (Pure)

    Abstract

    Background. Bacterial vaginosis (BV) is difficult to eradicate due to BV biofilms protecting BV bacteria (Gardnerella, Prevotella, and other genera). With the growing understanding of biofilms, we systematically reviewed the current knowledge on the efficacy of anti-BV biofilm agents. Methods. We searched literature in the Scopus, Medline, and Embase databases for empirical studies investigating substances for the treatment of BV biofilms or prevention of their recurrence and their efficacy and/or safety. Results. Of 201 unique titles, 35 satisfied the inclusion criteria. Most studies (89%) reported on preclinical laboratory research on the efficacy of experimental antibiofilm agents (80%) rather than their safety. Over 50% were published within the past 5 years. Agents were classified into 7 groups: antibiotics, antiseptics, cationic peptides, enzymes, plant extracts, probiotics, and surfactants/surfactant components. Enzymes and probiotics were most commonly investigated. Earlier reports of antibiotics having anti-BV biofilm activity have not been confirmed. Some compounds from other classes demonstrated promising anti-BV biofilm efficacy in early studies. Conclusions. Further research is anticipated on successful antibiofilm agents. If confirmed as effective and safe in human clinical trials, they may offer a breakthrough in BV treatment. With rising antibiotic resistance, antibiofilm agents will significantly improve the current standard of care for BV management.
    Original languageEnglish
    Pages (from-to)e508-e517
    Number of pages10
    JournalJournal of Infectious Diseases
    Volume230
    Issue number3
    DOIs
    Publication statusPublished - 2024

    Bibliographical note

    Publisher Copyright:
    © The Author(s) 2024.

    Keywords

    • bacterial vaginosis
    • biofilm
    • prevention
    • recurrence
    • treatment

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