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Hi Aunt Vadge, how do I treat BV caused by Prevotella?
From,
Jay
Age 29, NJ, USA
Hey Jay,
Prevotella is one of the more troublesome players in BV – it’s inflammatory and antibiotic-resistant, so when it’s present in real numbers (think roughly 10% or more of your microbiome) it can drive symptoms hard; below that, it usually isn’t the problem.
Its calling card is a sharp, ammonia-like or ‘cleaning product’ odour, because it produces a lot of ammonia, and it usually travels with Gardnerella. One quick heads-up for reading your results: the main vaginal species, Prevotella timonensis, has been reclassified as Hoylesella timonensis, so that’s the same bug under a new name if you see it on a microbiome report.
The antibiotic bit is worth knowing, because not all antibiotics help. Prevotella generally responds (for now) to metronidazole, clindamycin, amoxicillin/clavulanate, carbapenems and cephalosporins, though increased beta-lactamase activity makes some species resistant to plain beta-lactams – and crucially, some antibiotics can actually make it worse, including aminoglycosides, trimethoprim/sulfamethoxazole and quinolones.
So if you’re treating this, it really matters that your prescriber knows it’s Prevotella, not just ‘BV’.
On the natural-medicine side, because Prevotella is so inflammatory the approach that works best targets two things at once: calming the inflammation and actively rebuilding your protective lactobacilli so the Prevotella has nowhere to thrive – it’s not a single ‘kill’ step, it’s restoring the whole environment, and that’s very treatable.
And the most useful question of all is, if a Prevotella overgrowth keeps coming back, why is your microbiome letting it? That’s usually being driven by something else in your system, which is exactly the root-cause work that finally clears stubborn cases.
If you’d like that worked out and a plan for your specific picture, you can book an appointment with one of our practitioners – you’re not alone with this, and it’s very sortable.
Best,
Aunt Vadge
This is general information based on current research and our clinical experience, not a substitute for personalised medical advice.
