Usage
- Lactobacillus crispatus is primarily used for the prevention and treatment of bacterial vaginosis (BV), a condition characterized by an imbalance of vaginal flora. It may also be used to support vaginal health and prevent recurrent urinary tract infections (UTIs) in women.
- Pharmacological classification: Probiotic, vaginal flora normalizer.
- Mechanism of action: L. crispatus produces lactic acid, hydrogen peroxide, and bacteriocins, which help restore the normal vaginal pH and inhibit the growth of pathogenic bacteria associated with BV. It competes with harmful bacteria for nutrients and adhesion sites in the vagina.
Alternate Names
- There are no widely recognized alternate names for Lactobacillus crispatus. Strains like CTV-05 (Lactin-V) are specifically identified in some research and products.
- Brand names: Brand names vary depending on the product formulation and country of origin. Some products may contain L. crispatus in combination with other lactobacillus species.
How It Works
- Pharmacodynamics: L. crispatus primarily exerts its effects locally in the vagina. It lowers vaginal pH through lactic acid production, creating an environment less hospitable to BV-associated bacteria. Hydrogen peroxide and bacteriocins further inhibit the growth of these pathogens. The restoration of a healthy vaginal microbiota dominated by L. crispatus helps prevent BV recurrence.
- Pharmacokinetics: Oral administration of L. crispatus results in some colonization of the gastrointestinal tract. However, vaginal application leads to more effective colonization of the vagina. Data regarding absorption, metabolism, and elimination pathways are limited.
Dosage
Standard Dosage
Adults:
Oral: Up to 20 billion CFU daily for up to 12 months.
Vaginal: Up to 2 billion CFU daily for 5 days or twice weekly for 10 weeks, or as directed by a healthcare professional.
Children:
Dosage recommendations for children have not been established.
Special Cases:
Limited data exists regarding dosage adjustments for special populations. Clinicians should exercise caution and adjust dosage as needed based on individual patient response and tolerance.
Clinical Use Cases
Dosage recommendations for specific medical settings like intubation, surgical procedures, mechanical ventilation, and ICU use have not been established.
Dosage Adjustments
Data for dose modifications based on patient-specific factors are limited. Clinicians should consider factors like renal/hepatic function and other comorbidities when determining the appropriate dose.
Side Effects
Common Side Effects
Generally well-tolerated. Some individuals may experience mild gastrointestinal discomfort (gas, bloating) with oral administration.
Rare but Serious Side Effects
Rare reports of systemic infections (e.g., bacteremia) have been associated with probiotic use, particularly in immunocompromised individuals.
Long-Term Effects
Long-term effects of L. crispatus use are largely unknown.
Adverse Drug Reactions (ADR)
Serious ADRs are rare.
Contraindications
- Individuals with a known hypersensitivity to Lactobacillus species.
- Immunocompromised individuals should use L. crispatus with caution, as there is a theoretical risk of systemic infection.
Drug Interactions
- Limited information is available on specific drug interactions.
- Concomitant use of antibiotics may reduce the efficacy of L. crispatus.
Pregnancy and Breastfeeding
- Limited information available; generally considered safe when used as directed.
Drug Profile Summary
- Mechanism of Action: Restores vaginal flora by producing lactic acid, hydrogen peroxide, and bacteriocins.
- Side Effects: Generally well-tolerated; mild GI discomfort possible.
- Contraindications: Hypersensitivity to Lactobacillus, immunocompromised states.
- Drug Interactions: Limited information available.
- Pregnancy & Breastfeeding: Limited information; generally considered safe.
- Dosage: Oral: Up to 20 billion CFU daily; Vaginal: Up to 2 billion CFU daily or twice weekly.
Popular Combinations
- L. crispatus is often combined with other Lactobacillus species (e.g., L. rhamnosus, L. reuteri) in some probiotic formulations.
Precautions
- General Precautions: Monitor for signs of infection.
- Specific Populations: Exercise caution in immunocompromised individuals.
FAQs (Frequently Asked Questions)
Q1: What is the recommended dosage for Lactobacillus crispatus?
A: Oral: Up to 20 billion CFU daily. Vaginal: Up to 2 billion CFU daily or twice weekly.
Q2: What is the primary use of L. crispatus?
A: Prevention and treatment of bacterial vaginosis (BV).
Q3: How does L. crispatus work?
A: Produces lactic acid, hydrogen peroxide, and bacteriocins to restore vaginal flora and inhibit pathogen growth.
Q4: What are the common side effects of L. crispatus?
A: Generally well-tolerated; some may experience mild GI discomfort.
Q5: Are there any contraindications for L. crispatus use?
A: Hypersensitivity to Lactobacillus, immunocompromised states.
Q6: Can L. crispatus be used during pregnancy?
A: Limited information available; generally considered safe.
Q7: Does L. crispatus interact with any medications?
A: Limited information available; concomitant use of antibiotics may reduce efficacy.
Q8: How long can L. crispatus be used?
A: Oral administration has been studied for up to 12 months. Vaginal application regimens vary. Consult a healthcare professional for guidance.
Q9: Can L. crispatus prevent recurrent UTIs?
A: Some evidence suggests it may help prevent recurrent UTIs in women.
