Probiotics as an Adjunct to Antibiotics for Recurrent Bacterial Vaginosis

This randomized clinical trial aims to compare the recurrence of bacterial vaginosis (BV) in women receiving probiotics alongside antibiotic treatment versus women receiving antibiotic treatment alone. Bacterial vaginosis is a common vaginal condition that can recur after successful treatment. The main question this study aims to answer is: \- Does adding probiotics to standard antibiotic treatment reduce the recurrence of bacterial vaginosis compared with antibiotic treatment alone? The study will include 70 non-pregnant women aged 20-45 years diagnosed with recurrent bacterial vaginosis. All participants will initially receive metronidazole to treat the current episode. After successful treatment is confirmed, participants will be randomly assigned to one of two groups: * Group A: Probiotic capsules containing Lactobacillus plantarum, Lactobacillus rhamnosus, and Bifidobacterium animalis subsp. lactis, followed by monthly maintenance dosing for four months. * Group B: Placebo capsules, followed by the same monthly maintenance schedule. Participants will undergo monthly vaginal examinations for four months to assess whether bacterial vaginosis recurs. Recurrence will be diagnosed using Amsel\'s criteria, which include assessment of vaginal discharge, vaginal pH, clue cells on microscopy, and a characteristic fishy odor test. The researchers will compare the frequency of bacterial vaginosis recurrence between the two groups to determine whether adjunctive probiotic treatment reduces recurrence.