The current SatisFaction suRvEy on the use of Lactacyd(r) FH in PakiStani women presenting witH (FRESH) symptoms suggestive of vulvovaginal infections in gynaecological patients aimed at documenting the satisfaction of Pakistani women using lactic acid+lactoserum and thus investigating the effectiveness of topical application of this combination as an adjunct for symptomatic relief from pruritus, burning, and malodour often associated with VVIs. The secondary objective was to evaluate safety of topical application of lactic acid+lactoserum in achieving personal hygiene in women with RTIs.
The national, open-label, multi-centre, prospective survey was conducted at private consultation clinics in 14 cities across Pakistan from May to October 2010, and comprised women having VVIs. Administrative approval was taken from each participating investigator/clinic, and all the enrolled patients signed informed consent forms.
The study included married women aged >18 years presenting with clinical signs and symptoms of VVIs (e.g., BV, candidiasis, and trichomoniasis) such as pruritus, tenderness, erythema, malodour, and abnormal white or gray vaginal discharge; first and recurrent VVIs; and patients who were treated with antibiotics for current VVI.
At baseline visit (visit 1), data on the eligibility criteria, anthropometric characteristics, medical history, including history of diabetes, parity status and dysuria, along with symptoms of current VVIs, and findings of bimanual examinations were recorded on data collection forms (DCFs).
On the second visit, 14 days after enrolment (visit 2), compliance with the use of lactic acid+lactoserum, patient satisfaction questionnaire, and time taken for symptomatic relief of VVIs were noted on the DCFs.
Anthropometric characteristics, medical history, and symptoms of VVIs as assessed at visit 1 were noted (Table-1).
Median duration of the current episode of VVIs was 7 days (range: 1-150 days), while the mean number of episodes of VVIs in the previous year was 3.4 2.6.
In this nationwide patient satisfaction survey among women using lactic acid+lactoserum as an adjuvant therapy for treating VVIs, 88.6% were satisfied with the topical use, and 79.7% agreed that they would routinely use lactic acid+lactoserum for personal hygiene.
Adjuvant treatment with lactic acid and lactoserum with oral metronidazole demonstrated increased Lactobacilli colonisation and prevented recurrent BV.15 Another study showed that the combination lactic acid and lactoserum prevented recurrence BV after treatment and cure with oral metronidazole.18 Other studies reported symptomatic relief in patients having VVIs who used adjunctive treatment with combination of lactic acid and lactoserum.16,17 In a study in Indian women with VVIs, majority of patients who used lactic acid+lactoserum as an adjuvant treatment to antibiotics, reported reduction in itching (83.6%), burning/pain sensation (83.6%), and malodour (91.3%).
The combination of lactic acid and lactoserum was regarded as user-friendly (97.2%), gentle on skin (94.9%), and having pleasing aroma (95.2%).17 In line with these studies, our study showed that lactic acid+lactoserum demonstrated symptomatic relief in almost three-fourth of the patients having VVIs. It reduced malodour (80.1%), itching (78.5%), burning sensation (77.4%), and pain (65.6%) in almost 4 days of treatment.
To the best of our knowledge, this is the first multi-centre, open-label nationwide survey carried out in women with VVIs in Pakistan, which evaluated effectiveness and safety of lactic acid+lactoserum when used as an adjuvant therapy to routine treatment of VVIs.
Lactic acid+lactoserum demonstrated high percentage of satisfaction in Pakistani women with VVIs. The combination was apparently effective and safe when used as an adjunctive treatment of VVIs and offered symptomatic relief.