Fluconazole, an anti-fungal medication used to treat vaginal yeast infections, is occasionally paired with a probiotic supplement during treatment. The practice is relatively new and the research is far from conclusive, but there are studies that have found a higher rate of success using the combination therapy as opposed to just fluconazole. If your doctor has prescribed probiotics in conjunction with fluconazole, follow her dosing instructions carefully.
Bacteria: Good Versus Bad
Your body contains both good and bad bacteria. When the bad bacteria outnumber the good bacteria, you develop an infection. Antibiotics kill bacteria without discriminating between the good and the bad, so many doctors recommend probiotic supplements during the course of treatment. Probiotics are good bacteria, and consuming them during or after a course of antibiotic treatment helps restore your body's natural population of good bacteria. When normal levels are restored, the good bacteria can help destroy any lingering bad bacteria, ending the infection and preventing a new one from occurring.
Probiotics have general antimicrobial properties -- in other words, they kill more than just bad bacteria. A 2005 meta-analysis in the Czech journal "Ceska Gynekologie" found that multiple Lactobacillus strains demonstrated the ability to bind together in clusters, then bind to Candida cells, preventing them from becoming established in the tissue. Candida is a common infectious fungal strain and can linger in the body long after anti-fungal treatment is discontinued. Treatment-resistant Candida infections tend to repopulate after anti-fungal medication is stopped, leading to a new infection with yeast cells that are resistant to the medication.
In 2009, two studies published showed successful results using a combination anti-fungal/probiotic treatment plan. The study in the journal "Letters in Applied Microbiology" showed that women who had been diagnosed with vaginal Candida infections and received probiotic treatment alongside fluconazole showed 24 percent less vaginal discharge and 28 percent fewer yeast cells after four weeks. A study published in "Microbial Ecology in Health and Disease" found a similar success rate with the same treatment, but also found that the women who received the probiotics experienced fewer reoccurrences during the next 90 days.
If your doctor hasn't prescribed probiotics to go with your fluconazole therapy, don't use them without his permission. Lactobacillus probiotics were found to be most effective against Candida, but these particular strains can also cause bacterial infections in people with weakened immune systems. It's also not yet clear what form of probiotic is most effective for Candida treatment -- the successful studies used oral tablets, but according to the University of Maryland Medical Center, vaginal suppositories containing the bacteria may be more effective, and eating yogurt with active cultures may help as well. Consult your doctor if you think probiotics might help your treatment.
- "Ceska Gynekologie"; Antifungal Effect in Selected Natural Compounds and Probiotics and Their Possible Use in Prophylaxis of Vulvovaginitis; M. Hronek, et al.; September 2005
- "Microbial Ecology in Health and Disease"; Oral Use of Probiotics as an Adjunctive Therapy to Fluconazole in the Treatment of Yeast Vaginitis: A Study of Nigerian Women in an Outdoor Clinic; C. Anukam Kingsley, et al.; 2009
- "Applied Microbiology"; Improved Treatment of Vulvovaginal Candidiasis With Fluconazole Plus Probiotic Lactobacillus Rhamnosus GR-1 and Lactobacillus Reuteri RC-14; R.C.R. Martinez, et al.; March 2009
- PubMed Health: Fluconazole
- University of Maryland Medical Center: Candidiasis
- University of Maryland Medical Center: Lactobacillus Acidophilus