[ASC-media] Yoghurt won't stop thrush

Sarah Brooker sarah.brooker at ozemail.com.au
Fri Aug 27 13:26:05 EST 2004

Embargo 11am British Medical Journal - www.bmj.com

Yoghurt won’t stop thrush
Probiotics not always the right approach

Millions of women around the world have probably used yoghurt as a folk
remedy to prevent thrush while taking antibiotics. A Melbourne GP and PhD
student has proven that Lactobacillus acidophilus, a key bacterium in
yoghurt, was not effective in the prevention of thrush (‘vulvovaginitis’)
after antibiotics.

Her findings were published today in the eminent British Medical Journal
(BMJ). “It’s a reminder that all medicines, even natural ones need to be
tested,” says Dr Pirotta.

235 Melbourne women took probiotic (containing lactobacillus bacteria) or
placebo preparations orally or vaginally until four days after completion of
their antibiotic course. They recorded any symptoms and provided vaginal
swabs for analysis. The results were so clear cut that the trial was cut
short on ethical grounds.

Dr Pirotta was surprised by her results, given that the folk remedy was so
popular with women, including her own patients. “But at least now women can
be better informed and can choose to use effective treatments instead,” she
said. “Currently, there are no recommended medicines to prevent thrush, so
women should discuss their options with their health care providers.”

Around 50% of women will suffer a bout of thrush after antibiotics at least
once in their lifetime. Although thrush usually does not kill people, it
does have a big impact on women’s physical and emotional wellbeing, as well
as on their relationships. In 1995 the costs associated with diagnosing and
treating thrush in the United States were $US1.8 billion (1).

The clinical trial was instigated after Dr Pirotta’s earlier research that
found that around 40% of women had used yoghurt or Lactobacillus to try to
prevent or treat thrush after antibiotics. These women also reported that
they were concerned about getting thrush after antibiotics, and for a small
number, the concern was so great that they would choose not to take the
antibiotics (2).

She also found that more than two thirds of GPs and pharmacists that she
surveyed thought that oral yoghurt or Lactobacillus could be effective to
prevent thrush after antibiotics and they had recommended this therapy to
women when prescribing or dispensing antibiotics.

Dr Pirotta said that “complementary therapies probably have a lot to offer
in health care. It was disappointing to find that this type of Lactobacillus
was not effective in this case. But this is a reminder that all medicines,
even ‘natural’ ones, need to be tested, and wherever possible, treatments
should be based on evidence.”

“This simple and relatively inexpensive study will change how GPs advise
women about thrush prevention,” says Professor Michael Kidd, President of
the Royal Australian College of General Practitioners.  “It demonstrates
that research in general practice can help GPs deliver the best, most cost
effective and evidence based care. We need to invest more in this kind of
targeted medical research.”

Dr Pirotta was one of 15 early career scientists selected to take part in
the 2004 Fresh Science Awards held recently in Melbourne. The one who most
meets the program requirements will win a study tour of the UK courtesy of
the British Council Australia.

For interview: Contact Dr Marie Pirotta 0409 012 246, email
m.pirotta at unimelb.edu.au

Scientific references and links are online at www.freshscience.org

Media contact Sarah Brooker 0413 332 489 sarah at freshscience.org

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