We found that neither an accepted diagnostic definition nor a treatment has been established for GBS
vulvovaginitis. A review of the literature revealed 5 previous articles describing a combined total of 26 cases
of GBS vaginitis in the absence of other pathogens (1-5). GBS vulvovaginitis presents with complaints of
vulvar burning and clear or white vaginal discharge. The labia appear fiery-red, sometimes with fissures. It
has been reported in both celibate and non-celibate women. Cultures contain GBS at a high multiplicity:
>100,000,000 colony forming units (CFU)/g of vaginal fluid) or +4 growth and decreased lactobacillus. GBS
vaginitis is sometimes identified as aerobic vulvovaginitis. High colonization with GBS appears to provoke
the release of cytokines causing inflammation and a severe decrease in lactobacillus. Current first line of
treatment is oral penicillin or clindamycin. It was first noticed in 1976 in an original article in the American J
of OBGYN entitled: Antibiotic Treatment of Parturient Women Colonized with GBS, that oral antibiotics were
ineffective at permanently decreasing asymptomatic GBS vaginal colonization. Women will culture negative
for GBS immediately after 10-14 day regimens of antibiotics, but several days later the vagina is usually
recolonized. An optimal treatment scheme for eliminating either asymptomatic or symptomatic vaginal
GBS and simultaneously normalizing the vaginal ecosystem has not been established. Seven to 14 day
regimen of oral antibiotics may or may not permanently eliminate the symptoms of symptomatic infections
successfully. Adjunctive local therapies that have been used are estrogen crème, povidine gel, chlorhexidine
gel, and fresh garlic cloves cut in half. Fresh garlic releases allicin when cut. Allicin inhibits the growth of
GBS in all GBS strains tested (6), most likely by interfering with the metabolism of cysteine and the function
of the microtubules.
Eight patients with confirmed symptomatic vaginal GBS of 6 months to 4 years duration, not resolved by
course(s) of oral antibiotics, presented to our practice over 4 year period. All presented with red labia,
erythema and erosion of the vaginal walls. In addition, they all had one or more of the following: periodic
burning sensation in the vagina, pain following intercourse, dyspareunia, periodic pain on urination, fissures,
thick white odourless discharge, thick white putrid discharge, thick clear discharge, and nausea. (Table 1)
Ten to fourteen day courses of Clindamycin or Penicillin had temporarily relieved but did not permanently
resolve their symptoms. Several local antibiotics known to be effective against GBS were discussed with
these clients: Fresh garlic, chlorhexidine gel and/or povidine-iodine.
The women all successfully resolved the symptoms by using half a freshly cut clove of garlic inserted
vaginally at night and removed in the morning, for 3 to 6 weeks followed by maintenance doses of once
every 2-4 days. The women were unable to obtain chlorhexidine gel at pharmacies and found povidine to be
Long-term symptomatic group B streptococcal vulvovaginitis: eight cases resolved with freshly cut garlic.
Eur J Obstet Gynecol Reprod Biol. 2009 Sep;146(1):110-1. Epub 2009 Jun 23. PMID: 19552998
No abstract provided.