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Bakteriyel vajinozis tedavisinde intravajinal gaz ozon tedavisinin etkinliği ve güvenliği

Year 2025, Volume: 8 Issue: 5, 811 - 817, 16.09.2025
https://doi.org/10.32322/jhsm.1734344
https://izlik.org/JA39DZ49XC

Abstract

Özet

Amaçlar: Bu çalışmanın amacı, bakteriyel vajinozis (BV) tedavisinde intravajinal gaz ozon tekniğimizle ilgili deneyimlerimizi ve sonuçlarımızı retrospektif veri analiziyle paylaşmaktır.
Yöntemler: Salutem plus marka tıbbi ozon cihazı, 60 gama 200 cc gaz ozon, Amsel kriterlerine göre BV tanısı konulan 102 hastaya nazogastrik kateter yardımıyla 50 cc'lik şırıngalarla intravajinal olarak uygulandı. İşlem öncesi ve sonrası hemogram parametreleri kontrol edilen hastalar, tekrarlama açısından 1., 3., 6., 9. ve 12. ay klinik kontrollerine çağrıldı ve bu hastaların muayene bulguları ve dijital verileri tedavi, komplikasyonlar ve tekrarlama açısından retrospektif olarak analiz edildi.
Sonuçlar: Yaşamı tehdit eden herhangi bir komplikasyonla karşılaşılmadı. Minör yan etkiler gözlendi ve herhangi bir tedaviye gerek kalmadan kısa sürede kendiliğinden düzeldi. Tekrarlama oranlarının klasik rejim tedavilerine göre daha düşük olduğu görüldü. Ek olarak, 1 yıllık takipte en fazla 2 tekrar gözlendi.
Sonuçlar: Çalışmamız bakteriyel vajinozis tedavisinde intravajinal gaz ozon tedavisinin tedavisi, tekrarı ve komplikasyonlarının değerlendirilmesi açısından literatürdeki ilk örnektir. Güvenli bir tedavi şekli olarak kabul edilen intravajinal gaz ozon tedavisinin gelecekte daha da yaygınlaşacağını ve uygulama sayısının ve sıklığının daha da artacağını düşünüyoruz. Verilerimizi doğrulamak için daha fazla sayıda hasta ile daha fazla araştırma yapılmalıdır.

References

  • Coudray MS, Madhivanan P. Bacterial vaginosis-a brief synopsis of the literature. J Obstet Gynecol Reprod Biol. 2020;245:143-148. doi:10.1016/j.ejogrb.2019.12.035
  • Gardner HL, Dukes CD. Haemophilus vaginalis vaginitis: a newly defined specific infection previously classified “nonspecific” vaginitis. Am J Obstet Gynecol. 1955;69(5):962-976.
  • Ranjit E, Raghubanshi BR, Maskey S, Parajuli P. Prevalence of bacterial vaginosis and ıts association with risk factors among nonpregnant women: a hospital based study. Int J Microbiol. 2018;2018:8349601. doi: 10.1155/2018/8349601
  • Martin DH, Marrazzo JM. The vaginal microbiome: current understanding and future directions. J Infect Dis. 2016;214(Suppl 1): S36-S41. doi:10.1093/infdis/jiw184
  • Chen JY, Tian H, Beigi RH. Treatment considerations for bacterial vaginosis and the risk of recurrence. J Womens Health (Larchmt). 2009; 18(12):1997-2004. doi:10.1089/jwh.2008.1088
  • Koumans EH, Sternberg M, Bruce C, et al. The prevalence of bacterial vaginosis in the United States, 2001-2004; associations with symptoms, sexual behaviors, and reproductive health. Sex Transm Dis. 2007;34(11):864-869. doi:10.1097/OLQ.0b013e318074e565
  • Bradshaw CS, Brotman RM. Making inroads into improving treatment of bacterial vaginosis-striving for long-term cure. BMC Infect Dis. 2015; 15:1-12. doi:10.1186/s12879-015-1027-4
  • Zanardi I, Burgassi S, Paccagnini E, Gentile M, Bocci V, Travagli V. What is the best strategy for enhancing the effects of topically applied ozonated oils in cutaneous infections? Biomed Res Int. 2013;2013:702949. doi:10.1155/2013/702949
  • Ergani SY, Dilbaz B, Ergani HM, Tekin ÖM. Effect of intrauterine ozone therapy on Asherman syndrome, an experimental rat model. Eur J Obstet Gynecol Reprod Biol. 2022;277:90-96. doi:10.1016/j.ejogrb.2022.08.014
  • Sen S, Sen S. Ozone therapy a new vista in dentistry: integrated review. Med Gas Res. 2020;10(4):189-192. doi:10.4103/2045-9912.304226
  • Bjarnsholt T. The role of bacterial biofilms in chronic infections. APMIS Suppl. 2013;(136):1-51. doi:10.1111/apm.12099
  • Bialoszewski D, Pietruczuk-Padzik A, Kalicinska A, et al. Activity of ozonated water and ozone against Staphylococcus aureus and Pseudomonas aeruginosa biofilms. Med Sci Monit. 2011;17(11):BR339-BR344. doi:10.12659/msm.882044
  • Sagai M, Bocci V. Mechanisms of action ınvolved in ozone therapy: is healing induced via a mild oxidative stress? Med Gas Res. 2011;1:29. doi:10.1186/2045-9912-1-29
  • Rowen RJ. Ozone therapy as a primary and sole treatment for acute bacterial infection: case report. Med Gas Res. 2018;8(3):121-124. doi:10. 4103/2045-9912.241078
  • Bradshaw CS, Morton AN, Hocking J, et al. High recurrence rates of bacterial vaginosis over the course of 12 months after oral metronidazole therapy and factors associated with recurrence. J Infect Dis. 2006;193(11):1478-1486. doi:10.1086/503780
  • Bradshaw CS, Vodstrcil LA, Hocking JS, et al. Recurrence of bacterial vaginosis is significantly associated with posttreatment sexual activities and hormonal contraceptive use. Clin Infect Dis. 2013;56(6):777-786. doi:10.1093/cid/cis1030
  • Cook RL, Redondo-Lopez V, Schmitt C, Meriwether C, Sobel JD. Clinical, microbiological, and biochemical factors in recurrent bacterial vaginosis. J Clin Microbiol. 1992;30(4):870-877. doi:10.1128/jcm.30.4.870-877.1992
  • Marshall AO. Managing recurrent bacterial vaginosis: insights for busy providers. Sex Med Rev. 2015;3(2):88-92. doi:10.1002/smrj.45
  • Bagnall P, Rizzolo D. Bacterial vaginosis: a practical review. JAAPA. 2017;30(12):15-21. doi:10.1097/01.JAA.0000526770.60197.fa
  • Sobel JD, Ferris D, Schwebke J, et al. Suppressive antibacterial therapy with 0.75% metronidazole vaginal gel to prevent recurrent bacterial vaginosis. Am J Obstet Gynecol. 2006;194(5):1283-1289. doi:10.1016/j.ajog.2005.11.041
  • Mandhare M, Jagdale D, Gaikwad P, Gandhi P, Kadam V. Miracle of ozone therapy as an alternative medicine. Int J Pharm Chem Biol Sci. 2012;2(1):63-71.
  • Đuričić D, Valpotić H, Samardžija M. Prophylaxis and therapeutic potential of ozone in buiatrics: current knowledge. Anim Reprod Sci. 2015;159:1-7. doi:10.1016/j.anireprosci.2015.05.017
  • Wei A, Feng H, Jia XM, Tang H, Liao YY, Li BR. Ozone therapy ameliorates inflammation and endometrial injury in rats with pelvic inflammatory disease. Biomed Pharmacother. 2018;107:1418-1425. doi: 10.1016/j.biopha.2018.07.137
  • Đuričić D, Valpotić H, Žura Žaja I, Samardžija M. Comparison of intrauterine antibiotics versus ozone medical use in sheep with retained placenta and following obstetric assistance. Reprod Domest Anim. 2016; 51(4):538-540. doi:10.1111/rda.12715
  • Zargaran M, Fatahinia M, Zarei Mahmoudabadi A. The efficacy of gaseous ozone against different forms of Candida albicans. Curr Med Mycol. 2017;3(2):26-32. doi:10.18869/acadpub.cmm.3.2.26
  • Mehta SD. Systematic review of randomized trials of treatment of male sexual partners for improved bacteria vaginosis outcomes in women. Sex Transm Dis. 2012;39(10):822-830. doi:10.1097/OLQ.0b013e3182631d89
  • Vodstrcil LA, Plummer EL, Fairley CK, et al. Male-Partner treatment to prevent recurrence of bacterial vaginosis. N Engl J Med. 2025;392(10):947-957. doi:10.1056/NEJMoa2405404
  • Raba G, Durkech A, Malík T, Bassfeld D, Grob P, Hurtado-Chong A; Fluomizin Study Group. Efficacy of dequalinium chloride vs metronidazole for the treatment of bacterial vaginosis: a randomized clinical trial. JAMA Netw Open. 2024;7(5):e248661. doi:10.1001/jamanet workopen.2024.8661
  • Luo H, Zhou C, Zhou L, He Y, Xie RH. The effectiveness of vaginal microbiota transplantation for vaginal dysbiosis and bacterial vaginosis: a scoping review. Arch Gynecol Obstet. 2024;310(2):643-653. doi:10.1007/s00404-024-07611-1
  • Van de Wijgert JHHM, Jespers V. The role of lactobacilli in vaginal health and bacterial vaginosis: evidence from clinical studies. FEMS Microbiol Rev. 2020;44(6):773-792.
  • Machado D, Castro J, Palmeira-de-Oliveira A, Martinez-de-Oliveira J, Cerca N. Bacterial vaginosis biofilms: challenges to current therapies and emerging solutions. Front Microbiol. 2016;7:1528. doi:10.3389/fmicb.2015.01528
  • Yarustovskaya OV, Kulikov AG, Shtro LP. Combined treatment of patients with bacterial vaginosis using ozone therapy and an interferon inducer. Vopr Kurortol Fizioter Lech Fiz Kult. 2015;92(3):17-21. doi:10. 17116/kurort2015545-49
  • Khairy AM, Abdelkhalek AM, Elsharkawy M, et al. Intravaginal ozone insufflation for recurrent vulvovaginal candidiasis: a randomized clinical trial. Egypt Bullet Women Health J. 2021;11(3):45-53.
  • Alia A, Kholoud R. The impact of ozone on bacterial vaginosis biofilms: ultrastructural evidence via transmission electron microscopy. EJ Med. 2014;6(2):45-52.

Efficacy and safety of intravaginal gas ozone therapy in the treatment of bacterial vaginosis

Year 2025, Volume: 8 Issue: 5, 811 - 817, 16.09.2025
https://doi.org/10.32322/jhsm.1734344
https://izlik.org/JA39DZ49XC

Abstract

Aims: The aim of this study is to share our experiences and results with our intravaginal gas ozone technique in the treatment of bacterial vaginosis (BV) by retrospective data analysis.
Methods: Salutem plus brand medical ozone device, 60 gamma 200 cc gas ozone was administered intravaginally through 50 cc syringes with the help of a nasogastric catheter to 102 patients diagnosed with BV using Amsel criteria. Patients whose hemogram parameters were checked before and after the procedure were called for 1st, 3rd, 6th, 9th and 12th month clinical controls in terms of recurrence, and the examination findings and digital data of these patients were analyzed retrospectively in terms of treatment, complications and recurrence.
Results: No life-threatening complications were encountered. Minor adverse effects were observed and resolved spontaneously in a short time without the need for any treatment. Recurrence rates were observed to be lower than in classical regimen treatments. Additionally, no more than 2 recurrences were observed during 1-year follow-up.
Conclusion: Our study is the first example of the literature in terms of evaluation of treatment, recurrence and complications of intravaginal gas ozone therapy in the treatment of bacterial vaginosis. These finding suggest that intravaginal gas ozone therapy, which is considered a safe form of treatment, will become more widespread in the future and the number and frequency of its application will increase even more. Further investigation with a larger number of patients should be conducted to confirm our data.

References

  • Coudray MS, Madhivanan P. Bacterial vaginosis-a brief synopsis of the literature. J Obstet Gynecol Reprod Biol. 2020;245:143-148. doi:10.1016/j.ejogrb.2019.12.035
  • Gardner HL, Dukes CD. Haemophilus vaginalis vaginitis: a newly defined specific infection previously classified “nonspecific” vaginitis. Am J Obstet Gynecol. 1955;69(5):962-976.
  • Ranjit E, Raghubanshi BR, Maskey S, Parajuli P. Prevalence of bacterial vaginosis and ıts association with risk factors among nonpregnant women: a hospital based study. Int J Microbiol. 2018;2018:8349601. doi: 10.1155/2018/8349601
  • Martin DH, Marrazzo JM. The vaginal microbiome: current understanding and future directions. J Infect Dis. 2016;214(Suppl 1): S36-S41. doi:10.1093/infdis/jiw184
  • Chen JY, Tian H, Beigi RH. Treatment considerations for bacterial vaginosis and the risk of recurrence. J Womens Health (Larchmt). 2009; 18(12):1997-2004. doi:10.1089/jwh.2008.1088
  • Koumans EH, Sternberg M, Bruce C, et al. The prevalence of bacterial vaginosis in the United States, 2001-2004; associations with symptoms, sexual behaviors, and reproductive health. Sex Transm Dis. 2007;34(11):864-869. doi:10.1097/OLQ.0b013e318074e565
  • Bradshaw CS, Brotman RM. Making inroads into improving treatment of bacterial vaginosis-striving for long-term cure. BMC Infect Dis. 2015; 15:1-12. doi:10.1186/s12879-015-1027-4
  • Zanardi I, Burgassi S, Paccagnini E, Gentile M, Bocci V, Travagli V. What is the best strategy for enhancing the effects of topically applied ozonated oils in cutaneous infections? Biomed Res Int. 2013;2013:702949. doi:10.1155/2013/702949
  • Ergani SY, Dilbaz B, Ergani HM, Tekin ÖM. Effect of intrauterine ozone therapy on Asherman syndrome, an experimental rat model. Eur J Obstet Gynecol Reprod Biol. 2022;277:90-96. doi:10.1016/j.ejogrb.2022.08.014
  • Sen S, Sen S. Ozone therapy a new vista in dentistry: integrated review. Med Gas Res. 2020;10(4):189-192. doi:10.4103/2045-9912.304226
  • Bjarnsholt T. The role of bacterial biofilms in chronic infections. APMIS Suppl. 2013;(136):1-51. doi:10.1111/apm.12099
  • Bialoszewski D, Pietruczuk-Padzik A, Kalicinska A, et al. Activity of ozonated water and ozone against Staphylococcus aureus and Pseudomonas aeruginosa biofilms. Med Sci Monit. 2011;17(11):BR339-BR344. doi:10.12659/msm.882044
  • Sagai M, Bocci V. Mechanisms of action ınvolved in ozone therapy: is healing induced via a mild oxidative stress? Med Gas Res. 2011;1:29. doi:10.1186/2045-9912-1-29
  • Rowen RJ. Ozone therapy as a primary and sole treatment for acute bacterial infection: case report. Med Gas Res. 2018;8(3):121-124. doi:10. 4103/2045-9912.241078
  • Bradshaw CS, Morton AN, Hocking J, et al. High recurrence rates of bacterial vaginosis over the course of 12 months after oral metronidazole therapy and factors associated with recurrence. J Infect Dis. 2006;193(11):1478-1486. doi:10.1086/503780
  • Bradshaw CS, Vodstrcil LA, Hocking JS, et al. Recurrence of bacterial vaginosis is significantly associated with posttreatment sexual activities and hormonal contraceptive use. Clin Infect Dis. 2013;56(6):777-786. doi:10.1093/cid/cis1030
  • Cook RL, Redondo-Lopez V, Schmitt C, Meriwether C, Sobel JD. Clinical, microbiological, and biochemical factors in recurrent bacterial vaginosis. J Clin Microbiol. 1992;30(4):870-877. doi:10.1128/jcm.30.4.870-877.1992
  • Marshall AO. Managing recurrent bacterial vaginosis: insights for busy providers. Sex Med Rev. 2015;3(2):88-92. doi:10.1002/smrj.45
  • Bagnall P, Rizzolo D. Bacterial vaginosis: a practical review. JAAPA. 2017;30(12):15-21. doi:10.1097/01.JAA.0000526770.60197.fa
  • Sobel JD, Ferris D, Schwebke J, et al. Suppressive antibacterial therapy with 0.75% metronidazole vaginal gel to prevent recurrent bacterial vaginosis. Am J Obstet Gynecol. 2006;194(5):1283-1289. doi:10.1016/j.ajog.2005.11.041
  • Mandhare M, Jagdale D, Gaikwad P, Gandhi P, Kadam V. Miracle of ozone therapy as an alternative medicine. Int J Pharm Chem Biol Sci. 2012;2(1):63-71.
  • Đuričić D, Valpotić H, Samardžija M. Prophylaxis and therapeutic potential of ozone in buiatrics: current knowledge. Anim Reprod Sci. 2015;159:1-7. doi:10.1016/j.anireprosci.2015.05.017
  • Wei A, Feng H, Jia XM, Tang H, Liao YY, Li BR. Ozone therapy ameliorates inflammation and endometrial injury in rats with pelvic inflammatory disease. Biomed Pharmacother. 2018;107:1418-1425. doi: 10.1016/j.biopha.2018.07.137
  • Đuričić D, Valpotić H, Žura Žaja I, Samardžija M. Comparison of intrauterine antibiotics versus ozone medical use in sheep with retained placenta and following obstetric assistance. Reprod Domest Anim. 2016; 51(4):538-540. doi:10.1111/rda.12715
  • Zargaran M, Fatahinia M, Zarei Mahmoudabadi A. The efficacy of gaseous ozone against different forms of Candida albicans. Curr Med Mycol. 2017;3(2):26-32. doi:10.18869/acadpub.cmm.3.2.26
  • Mehta SD. Systematic review of randomized trials of treatment of male sexual partners for improved bacteria vaginosis outcomes in women. Sex Transm Dis. 2012;39(10):822-830. doi:10.1097/OLQ.0b013e3182631d89
  • Vodstrcil LA, Plummer EL, Fairley CK, et al. Male-Partner treatment to prevent recurrence of bacterial vaginosis. N Engl J Med. 2025;392(10):947-957. doi:10.1056/NEJMoa2405404
  • Raba G, Durkech A, Malík T, Bassfeld D, Grob P, Hurtado-Chong A; Fluomizin Study Group. Efficacy of dequalinium chloride vs metronidazole for the treatment of bacterial vaginosis: a randomized clinical trial. JAMA Netw Open. 2024;7(5):e248661. doi:10.1001/jamanet workopen.2024.8661
  • Luo H, Zhou C, Zhou L, He Y, Xie RH. The effectiveness of vaginal microbiota transplantation for vaginal dysbiosis and bacterial vaginosis: a scoping review. Arch Gynecol Obstet. 2024;310(2):643-653. doi:10.1007/s00404-024-07611-1
  • Van de Wijgert JHHM, Jespers V. The role of lactobacilli in vaginal health and bacterial vaginosis: evidence from clinical studies. FEMS Microbiol Rev. 2020;44(6):773-792.
  • Machado D, Castro J, Palmeira-de-Oliveira A, Martinez-de-Oliveira J, Cerca N. Bacterial vaginosis biofilms: challenges to current therapies and emerging solutions. Front Microbiol. 2016;7:1528. doi:10.3389/fmicb.2015.01528
  • Yarustovskaya OV, Kulikov AG, Shtro LP. Combined treatment of patients with bacterial vaginosis using ozone therapy and an interferon inducer. Vopr Kurortol Fizioter Lech Fiz Kult. 2015;92(3):17-21. doi:10. 17116/kurort2015545-49
  • Khairy AM, Abdelkhalek AM, Elsharkawy M, et al. Intravaginal ozone insufflation for recurrent vulvovaginal candidiasis: a randomized clinical trial. Egypt Bullet Women Health J. 2021;11(3):45-53.
  • Alia A, Kholoud R. The impact of ozone on bacterial vaginosis biofilms: ultrastructural evidence via transmission electron microscopy. EJ Med. 2014;6(2):45-52.
There are 34 citations in total.

Details

Primary Language English
Subjects Obstetrics and Gynaecology
Journal Section Research Article
Authors

Savaş Özgür Ağlamış 0000-0003-1803-106X

Seval Yılmaz Ergani 0000-0002-7017-8854

Eda Adeviye Şahin 0000-0003-4004-8167

Hanifi Şahin

Turan Şahin 0000-0003-1616-9735

Submission Date July 4, 2025
Acceptance Date August 4, 2025
Publication Date September 16, 2025
DOI https://doi.org/10.32322/jhsm.1734344
IZ https://izlik.org/JA39DZ49XC
Published in Issue Year 2025 Volume: 8 Issue: 5

Cite

AMA 1.Ağlamış SÖ, Yılmaz Ergani S, Adeviye Şahin E, Şahin H, Şahin T. Efficacy and safety of intravaginal gas ozone therapy in the treatment of bacterial vaginosis. J Health Sci Med / JHSM. 2025;8(5):811-817. doi:10.32322/jhsm.1734344

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