pHyph, a novel antibiotic-free treatment for bacterial vaginosis, promotes Lactobacillus growth and reduces the abundance of pathogens in the vagina.

Lahtinen E, Hugerth LW, Edfeldt G, Säfholm A, Kornfält S, Engstrand L, Strevens H, Schuppe-Koistinen I

AJOG Glob Rep 5 (4) 100566 [2025-11-00; online 2025-09-14]

Bacterial vaginosis (BV) is the most common vaginal infection among women of reproductive age worldwide, caused by dysbiosis of the vaginal microbiome. Despite its prevalence, the underlying molecular mechanisms remain poorly understood, making diagnosis and treatment challenging. Although antibiotics are the standard therapy, recurrence rates are high, up to 50% within 1 year, and repeated treatments contribute to the rise of antimicrobial resistance. There is an urgent need for alternative, sustainable, and microbiome-friendly treatment options. To evaluate whether pHyph, a novel antibiotic-free treatment, promotes a shift in the vaginal microbiome toward a health-associated composition in women with clinically diagnosed BV. In a randomized, double-blind, placebo-controlled trial, vaginal swabs were collected from 152 women diagnosed with BV. Microbiome composition was assessed before and after a 6-day treatment with pHyph or a placebo-like comparator, using qPCR targeting 25 bacterial, 2 viral, and 8 eukaryotic species. pHyph significantly increased the abundance of Lactobacillus iners, Lactobacillus gasseri and Lactobacillus jensenii after treatment, while decreasing the abundance of BV-associated species, such as Gardnerella vaginalis, BVAB2, and Fannyhessea vaginae (Wilcoxon signed rank test, P<.05). The growth-promoting effect on Lactobacillus was more pronounced in women who had detectable levels at baseline. Notably, a substantial number of participants in the pHyph group (n=33) transitioned to a Lactobacillus-dominated community state type (CST), compared to none in the comparator group. pHyph supports BV resolution by promoting a Lactobacillus-dominated vaginal microbiome and reducing BV-associated species, offering a promising antibiotic-free alternative.

PubMed 41321665

DOI 10.1016/j.xagr.2025.100566

Crossref 10.1016/j.xagr.2025.100566

pmc: PMC12663627
pii: S2666-5778(25)00127-3