Modulating the vaginal microbiome: the need for a bridge between science and practice.

Infections of the urinary and reproductive tracts continue to afflict hundreds of millions of women and girls each year. For those fortunate enough to have access to medical care, the diagnostic and treatment measures used on them have changed little in 40 years and remain far from adequate. The development of alternatives, such as probiotics, has been hindered by lack of funding, but now face bureaucratic barriers that reflect an outdated regulatory system more concerned with policies than care for the patient. The technological advances emerging from human microbiome studies are making it possible to generate a completely new understanding of how microbes interact with the host, what influences them, and when the result is an aberration requiring intervention. But until bridges are built between scientific progress and practice, it is women and girls who will continue to receive suboptimal care for their often persistent and debilitating conditions.