Updated: Mar 2
500 million women have no alternative but to treat Candidiasis and Bacterial Vaginosis with drugs that are not only ineffective but also increase global antimicrobial resistance.
Up to 75% of women will develop candidiasis in their lifetime, and at least 29% will get Bacterial Vaginosis each year. While these are unpleasant infections that are hard to fix with antimicrobial drugs, the current treatment options also have multiple lasting negative effects on global health.
How did we get there, and what can we do to mitigate this situation?
A rich ecosystem that needs better care
Around half of the cells in our bodies are not actually human. Trillions of microorganisms such as bacteria and fungi use our bodies as a home. In return, they help us digest food, protect us from infections, and neutralize toxins. While most of the bacteria live in our gut, vaginal flora takes a solid place at the top of the list.
The vaginal microbiome is a finely balanced micro-ecosystem containing different types of microorganisms, including multiple strains of fungi and at least 581 types of bacteria. The imbalance created by overgrowth of the harmful bacteria causes vaginal infections such as Candidiasis or Bacterial Vaginosis. The only way to treat these health issues today is by using antibiotic or antimycotic drugs.
Unfortunately, antimicrobial drugs wipe out both the good and the harmful microorganisms from the vaginal microbiome and can cause vaginal dysbiosis. This condition is connected with a higher risk of pre-term delivery, miscarriage, infertility, and the development of cervical cancer.
Current treatments create a vicious circle
Most bacteria from the lactobacillus family are highly beneficial to women’s health and should make up most of the vaginal microbiome. They are basis of women’s innate defence mechanisms protecting vaginal environment from infections.
For instance, candidiasis is a fungal infection caused by the overgrowth of candida yeast. Some strains of it, such as candida albicans, are typically treated with antifungal drugs, while the candida glabrata strain can only be fixed with medicine containing boric acid. The first treatment wipes out vaginal microbiota and increases the growth of pathogens. Due to that, 40%-45% of women will have two or more episodes of the infection due to this. At the same time, European Chemicals Agency warns against the regular use of boric acid due to the fertility issues it can cause. It may be toxic to the embryo during pregnancy.
Together with the beneficial lactobacilli, vaginal flora also contains harmful bacteria such as gardnerella vaginalis. An overgrowth of the latter will cause the development of Bacterial Vaginosis, an unpleasant condition that can affect any 15–50-year-old woman.
Typically, this infection gets treated with antibiotics. But this solution wipes out both good and harmful bacteria, causing vaginal dysbiosis. After several cycles of this treatment, the microbiota has trouble restoring its lactobacilli to the healthy proportion, which causes a never-ending cycle of issues and a 80% chance of relapse in 3-12 months.
The intensive use of antimicrobial drugs increases the development of new strains of microorganisms resistant to the typical treatment, becoming one of the most dangerous threats to public health.
The dark side of antimicrobial resistance
Obviously, both of these treatments are not only ineffective due to the high reoccurrence rate but create new lasting issues for women’s health.
At the same time, regularly using antimicrobial treatments – both antibiotic and antifungal drugs – increases the risk of bacteria and fungus developing resistance to treatment, which is a dangerous threat to the rest of the population.
The leading health organizations and researchers are already sounding the alarm. World Health Organization has named antimicrobial resistance one of the top 10 threats to public health. The Lancet published that in 2019 5 million people died from illnesses in which antimicrobial resistance played a part. It is especially dangerous to people living in the most vulnerable communities that do not have enough resources to address the issues.
The increase in drug-resistant pathogens means that the typical treatments for the most common and severe health issues will no longer be effective.
The World Health Organization states that there are not enough innovative types of antimicrobial drugs created at the moment. It means that soon we might not have enough new tools to fight the new kinds of “superbugs” – the bacteria and fungi pathogens that do not respond to traditional treatments.
Antimicrobial resistance will impact all medical areas, from treating pneumonia and urinary tract infections to preventing post-operative sepsis. The rapid evolution of new resistant strains of microbes, combined with the slow development of new types of treatment, is a recipe for disaster.
The need for a new type of solution
So, if the common path toward female health is not optimal, what are the alternatives?
The ideal treatment for Candidiasis and Bacterial Vaginosis will have to focus on several main characteristics. It would not rely on antimicrobial treatment but embrace healthy vaginal flora by creating an environment where the beneficial lactobacilli can thrive.
The next generation of treatment for vaginal infections would have to:
● Stay antibiotic-free to decrease the global threat of developing new strains of pathogens.
● Focus on embracing healthy vaginal microbiota without regularly eliminating all beneficial bacteria and fungi.
● Kill the pathogens, but save the beneficial types of bacteria and fungi.
● Protect and nourish the lactobacilli to ensure the health of the vaginal microbiome.
● Stop the recurrence of vaginal infections by maintaining a healthy microbiota balance during the entire cycle, including menstruation.
Even though currently there is no such product on the market, the Avodes team is developing a solution that covers all of these crucial criteria.
Antibiotic-free solution for female health
Avodes treatment for Bacterial Vaginosis and Candidiasis addresses the underlying issue behind the infection – the disbalance of the vaginal microbiota. The treatment eliminates the consequence of wiping out all microorganisms and creates a healthy environment for good bacteria to thrive. This prevents relapses and reduces the risk of developing more serious health issues.
The company was created back in 2018 and has already successfully validated in pilot clinical trial its first product – a patented all-natural menstrual sponge Spomfy. Avodes was selected for the “Women TechEU” pilot call by the European Innovations Ecosystem program of Horizon Europe. The company was also nominated for the Seal of Excellence in the European Union’s EIC Accelerator, getting noticed among 6,500 startups.
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