The prevalence of bacterial vaginosis (BV) among women of reproductive age is 29%. BV arises from a vaginal imbalance marked by reduced levels of lactic acid-producing lactobacilli and an overgrowth of pathogenic anaerobes. The multifactorial nature of BV’s pathogenesis complicates its treatment. Current antibiotic therapy exhibits a recurrence rate of about 60% within a year. Recurrence can be caused by antibiotic treatment failure (e.g., due to antimicrobial resistance), the persistence of residual infections (e.g., due to biofilm formation), and re-infection. Because of the high recurrence rates, alternative therapies are required. Medical-grade honey (MGH), known for its antimicrobial and wound healing properties in wound care, emerges as a potential novel therapy for BV. MGH exerts broad-spectrum antimicrobial activity, employing multiple mechanisms to eliminate the risk of resistance. For example, the low pH of MGH and the production of hydrogen peroxide benefit the microbiota and helps restore the natural vaginal balance. This is supported by in vitro studies demonstrating that MGH has an antibacterial effect on several pathogenic bacteria involved in the pathophysiology of BV, while lactobacilli and the vaginal microenvironment can be positively affected. In contrast to antibiotics, MGH exerts anti-biofilm activity, affects the microbiome as pre- and probiotic, and modulates the vaginal microenvironment through its anti-inflammatory, anti-oxidative, physicochemical, and immunomodulatory properties. More clinical research is required to confirm the positive effect of MGH on BV and to investigate the long-term cure rate.

中文翻译：

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医用级蜂蜜作为细菌性阴道病的潜在新疗法

育龄妇女细菌性阴道病 (BV) 的患病率为 29%。 BV 是由阴道失衡引起的，其特征是产乳酸的乳酸杆菌水平降低和致病性厌氧菌过度生长。 BV 发病机制的多因素性质使其治疗变得复杂。目前的抗生素治疗一年内复发率约为60%。抗生素治疗失败（例如，由于抗菌素耐药性）、残留感染的持续存在（例如，由于生物膜的形成）和再次感染可能导致复发。由于复发率高，需要替代疗法。医用级蜂蜜 (MGH) 以其在伤口护理中的抗菌和伤口愈合特性而闻名，成为细菌性阴道病的潜在新型疗法。 MGH 发挥广谱抗菌活性，采用多种机制消除耐药风险。例如，MGH 的低 pH 值和过氧化氢的产生有利于微生物群，有助于恢复自然阴道平衡。体外研究证明，MGH 对 BV 病理生理学中涉及的几种致病菌具有抗菌作用，同时乳酸杆菌和阴道微环境也会受到积极影响。与抗生素相比，MGH 发挥抗生物膜活性，作为益生菌和益生菌影响微生物群，并通过其抗炎、抗氧化、理化和免疫调节特性调节阴道微环境。需要更多的临床研究来证实 MGH 对 BV 的积极作用并调查长期治愈率。