Lactobacteria LCR35 for prevention of relapse of vulvovaginal candidiasis: results of the multicenter open non-interventional study

Manukhin I.B., Abashova E.I., Bazina M.I., Gerasimov A.M., Katkova N.Yu., Maltseva L.I., Olina A.A., Tkachenko L.V.

1 Moscow State University of Medicine and Dentistry named after A.I. Evdokimov, Moscow, Russia; 2 D.O. Ott Scientific Research Institute of Obstetrics and Gynecology, St. Petersburg, Russia; 3 Krasnoyarsk State Medical University named after prof. V.F. Voyno-Yasenetskii, Krasnoyarsk, Russia; 4 Ivanovo State Medical Academy, Ivanovo, Russia; 5 Privolzhsky Research Medical University, Nizhny Novgorod, Russia; 6 Kazan State Medical Academy, Kazan, Russia; 7 Volgograd State Medical University, Volgograd, Russia
Objective. To evaluate the efficacy and safety of the preparation containing the culture of lactobacilli LCR35 (vaginal capsules) in preventing recurrence of vulvovaginal candidiasis after local and/or systemic treatment with antifungal drugs.
Subjects and methods. A total of 800 patients diagnosed with acute vulvovaginal candidiasis (VVC) participated in the study. Depending on the therapy the patients were divided into two groups. Patients in group 1 (n = 200) received a course of VVC therapy with local and/or systemic antifungal drugs. Patients of group 2 (n = 600) received a course of VVC therapy with local and/or systemic antifungal drugs, and then a preparation containing a culture of lactobacilli LCR35 (lactogynal) in one capsule vaginally at night for 21 days. The period of dynamic observation of patients after the end of the therapy was five months, during which the recurrence of VVC was recorded. The study also assessed the level of patients’ adherence to the therapy using a multifactorial questionnaire. Statistical data analysis was performed using IBM SPSS 23.
Results. The period of time before the relapse of VVC was significantly longer in group 2 than in group 1, it was 98.08 ± 7.66 days and 86.19 ± 3.91 days, respectively, p = 0.037. The incidence of relapses of VVC was significantly lower in group 2 (4.7%) compared to group 1 (34.9%), p < 0.001. Evaluation of patients’ adherence to the treatment with the investigational drug lactogynal showed a high level (178.16 ± 1.16 points). The treatment groups analyzed were comparable in the number and severity of adverse events.
Conclusion. The presented results demonstrate the efficacy and safety of the preparation containing the culture of lactobacilli LCR35 (lactogynal) in the complex therapy of VVC.


vulvovaginal candidiasis


1. Workowski K.A., Bolan G.A.; Centers for Disease Control and Prevention. Sexually transmitted diseases treatment guidelines, 2015. MMWR Recomm. Rep. 2015; 64(RR-03): 1-137.

2. Vermitsky J.P., Self M.J., Chadwick S.G., Trama J.P., Adelson M.E., Mordechai E., Gygax S.E. Survey of vaginal-flora Candida species isolates from women of different age groups by use of species-specific PCR detection. J. Clin. Microbiol. 2008; 46(4): 1501-3.

3. Кира Е.Ф. Пробиотики в гинекологической практике. Журнал Российского общества акушеров-гинекологов. 2008; 3: 6-11. [Kira E.F. Probiotics in gynecological practice. Journal of Russian Society of Obstetricians and Gynecologists. 2008; 3: 6-11. (in Russian)]

4. McClelland R.S., Richardson B.A., Hassan W.M., Graham S.M., Kiarie J., Baeten J.M. et al. Prospective study of vaginal bacterial flora and other risk factors for vulvovaginal candidiasis. J. Infect. Dis. 2009; 199(12): 1883-90.

5. Манухин И.Б., Силаев К.А., Вученович Ю.Д. Влияние современной методики дородовой психопрофилактической подготовки беременных и альтернативных способов вагинального родоразрешения на течение и исход родов. Акушерство и гинекология. 2018; 2: 115-9. [Manukhin I.B., Silaev K.A., Vuchenovich Yu.D. The impact of modern methods of prenatal psychoprophylactic preparation of pregnant women and alternative ways of vaginal delivery on the course and outcome of childbirth. Obstetrics and gynecology. 2018; 2: 115-9. (in Russian)]

6. Прилепская В.Н., Мирзабалаева А.К., Кира Е.Ф., Гомберг М.А., Аполихина И.А., Байрамова Г.Р. Федеральные клинические рекомендации «Диагностика и лечение заболеваний, сопровождающихся патологическими выделениями из половых путей женщин». М.: Российское общество акушеров-гинекологов; 2013. [Prilepskaya V.N., Mirzabalayeva A.K., Kira E.F., Gomberg M.A., Apolikhina I.A., Bayramova G.R. Federal clinical guidelines “Diagnosis and treatment of diseases involving pathological secretions from the genital tract of women.” M .: Russian Society of Obstetricians and Gynecologists; 2013. (in Russian)]

7. Манухин И.Б., Силаев К.А. Роль психопрофилактической подготовки беременных к родам. Российский вестник акушера-гинеколога. 2016; 16(6): 9-13. [Manukhin I.B., Silaev K.A. The role of psychoprophylactic preparation of pregnant women for childbirth. Russian Bulletin of the obstetrician-gynecologist. 2016; 16 (6): 9-13. (in Russian)]

8. Zhou X., Westman R., Hickey R., Hansmann M.A., Kennedy C., Osborn T.W., Forney L.J. Vaginal microbiota of women with frequent vulvovaginal candidiasis. Infect. Immun. 2009; 77(9): 4130-5.

9. Swidsinski A., Guschin A., Tang Q., Dörffel Y., Verstraelen H., Tertychnyy A. et al. Vulvovaginal Candidiasis: Histologic lesions are primarily polymicrobial and invasive and do not contain biofilms. Am. J. Obstet. Gynecol. 2018; 25 October.

10. Babic M., Hukic M. Candida albicans and non-albicans species as etiological agent of vaginitis in pregnant and non-pregnant women. Bosn. J. Basic Med. Sci. 2010; 10(1): 89-97.

11. Kern A.M., Bohbot J.M., Cardot J.M. Traitement préventif de la candidose vulvovaginale récidivante par probiotique vaginal: résultats de l’étude observationnelle Candiflore. La Lettre du Gynécologue. 2012; 370: 34-7.

12. Dan M., Leshem Y., Yeshaya A. Performance of a rapid yeast test in detecting Candida spp. in the vagina. Diagn. Microbiol. Infect. Dis. 2010; 67: 52.

13. Bauters T.G., Dhont M.A., Temmerman M.I., Nelis H.J. Prevalence of vulvovaginal candidiasis and susceptibility to fluconazole in women. Am. J. Obstet. Gynecol. 2002; 187(3): 569-74.

14. Linhares I.M., Summers P.R., Larsen B., Giraldo P.C., Witkin S.S. Contemporary perspectives on vaginal pH and lactobacilli. Am. J. Obstet. Gynecol. 2011; 204(2): 120. e1-5.

15. Paiva L.C., Vidigal P.G., Donatti L., Svidzinski T.I., Consolaro M.E. Assessment of in vitro biofilm formation by Candida species isolates from vulvovaginal candidiasis and ultrastructural characteristics. Micron. 2012; 43(2-3): 497-502.

16. Coudeyras S., Jugie G., Vermerie M., Forestier C. Adhesion of human probiotic Lactobacillus rhamnosus to cervical and vaginal cells and interaction with vaginosis-associated pathogens. Infect. Dis. Obstet. Gynecol. 2008; 2008: 549640.

17. Савичева А.М. Рыбина Е.В. Исследование in vitro роста, размножения, антибиотикорезистентности, конкурентных взаимоотношений штамма Lactobacillus casei rhamnosus. Акушерство и гинекология. 2014; 7: 79-83. [Savicheva A.M. Rybina E.V. In vitro study of growth, reproduction, antibiotic resistance, competitive relationships of the strain Lactobacillus casei rhamnosus. Obstetrics and gynecology. 2014; 7: 79-83. (in Russian)]

18. Башмакова Н.В., Волкова Н.Ю., Гнатко Е.П., Данькова И.В., Доброхотова Ю.Э., Карахалис Л.Ю., Мальцева Л.И., Наделяева Я.Г., Потапов В.А., Серова О.Ф., Сутурина Л.В., Тарасова М.А., Татарчук Т.Ф. Пробиотик для профилактики рецидивов вульвовагинального кандидоза (результаты международного многоцентрового открытого исследования револакт). Акушерство и гинекология. 2017; 6: 135-42. [Bashmakova, N.V., Volkova, N.Yu., Gnatko, EP, Dan’kova, I.V., Dobrokhotova, Yu.E., Karahalis, L.Yu., Maltseva, L.I., Nadelyaeva, Ya.G., Potapov V.A., Serova OF.F., Suturina L.V., Tarasova M.A., Tatarchuk T.F. Probiotic for the prevention of recurrence of vulvovaginal candidiasis (results of an international multicenter open source study of revolact). Obstetrics and gynecology. 2017; 6: 135-42. (in Russian)]

19. Сгибнев А.В., Кремлева Е.А. Потенцирование активности антибиотиков метаболитами нормальной вагинальной микрофлоры. Акушерство и гинекология. 2017; 3:108-14. [Sgibnev A.V., Kremleva E.A. Potentiation of antibiotic activity by metabolites of normal vaginal microflora. Obstetrics and gynecology. 2017; 3: 108-14. (in Russian)]

20. Сгибнев А.В., Кремлева Е.А., Щетинина Ю.С., Черкасова Ю.И. Совместное применение антимикробных и пробиотических препаратов как способ повышения эффективности терапии генитальных инфекций. Акушерство и гинекология. 2018; 4: 113-8. [Sgibnev A.V., Kremleva E.A., Schetinina Yu.S., Cherkasova Yu.I. The combined use of antimicrobial and probiotic drugs as a way to increase the effectiveness of treatment of genital infections. Obstetrics and gynecology. 2018; 4: 113-8.(in Russian)]

Received 30.11.2018

Accepted 07.12.2018

About the Authors

Manukhin, Igor B., MD, Honored Doctor of Russia, professor, Department of Obstetrics and Gynecology, Medical Faculty, Moscow State University of Medicine and Dentistry, Ministry of Health of Russia.
127473, Russia, Moscow, Delegatskaya str. 20, bldg. 1. Tel.: +74991782831. E-mail:
Abashova, Elena I., PhD, senior researcher, Department of Endocrinology Reproduction, D.O. Ott Research Institute of Obstetrics, Gynecology and Reproduction.
199034, Russia, St. Petersburg, Mendeleevskaya line str. 3. Tel.: +78123289820, +79219459090. E-mail:
Bazina, Marina I., MD, professor, Department of Obstetrics and Gynecology, Krasnoyarsk State Medical University named after prof. V.F. Voyno-Yasenetskii.
660034, Russia, Krasnoyarsk, Krasnoyarskiy rabochiy pr. 170
Maltseva, Larisa I., MD, professor, Department of obstetrics and gynecology № 1, Kazan State Medical Academy.
420012, Russia, Kazan, Mushtari str.1. Tel: +7 (843)233-34-87.
Olina, Anna A., MD, professor of Department of obstetrics and gynecology, Academician E.A. Vagner Perm State Medical University, Ministry of Health of Russia.
614990, Russia, Perm, Petropavlovskaya str. 26. Tel.: +73422172020. E-mail:
Tkachenko, Ludmila V., MD, professor, head of Department of Obstetrics and Gynecology, Faculty of advanced training of doctors, Volgograd State Medical University.
400131, Russia, Volgograd, Pavshikh Bortsov Sq. str. 1. Tel.: +78442385005. E-mail:
Katkova, Nadezhda Yu., MD, associate professor of the Department of Obstetrics and Gynecology, Postgraduate Education Faculty, Nizhny Novgorod State Medical Academy. 603005, Russia, Nizhny Novgorod, Minin and Pozharsky sq. str. 10/1. Tel.: +78314657575. E-mail:
Alexey, Gerasimov M., MD, Ivanovo State Medical Academy. 153462, Russia, Ivanovo, F. Engels Ave. str. 8. Tel.: +74932301766

For citations: Manukhin I.B., Abashova E.I., Bazina M.I., Gerasimov A.M., Katkova N.Yu., Maltseva L.I., Olina A.A., Tkachenko L.V. Lactobacteria LCR35 for prevention of relapse of vulvovaginal candidiasis: results of the multicenter open non-interventional study. Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2018; (12): 132-40. (in Russian)

Similar Articles

By continuing to use our site, you consent to the processing of cookies that ensure the proper functioning of the site.