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Among Swedish patients, doxycycline was shown to be relatively ineffective (with a cure rate of 48% for women and 38% for men); and treatment with a single dose of azithromycin is not prescribed due to it inducing antimicrobial resistance. The five-day treatment with azithromycin showed no development of antimicrobial resistance. [49]
A single study suggests superiority of azithromycin over doxycycline. [34] Another alternative is to use a parenteral regimen with ceftriaxone or cefoxitin plus doxycycline. [ 27 ] Clinical experience guides decisions regarding transition from parenteral to oral therapy, which usually can be initiated within 24–48 hours of clinical improvement.
Diagnosis is suspected based on the symptoms, and may be verified by testing the vaginal discharge and finding a higher than normal vaginal pH, and large numbers of bacteria. [6] BV is often confused with a vaginal yeast infection or infection with Trichomonas. [7] Usually treatment is with an antibiotic, such as clindamycin or metronidazole.
Women with aerobic vaginitis usually have a thinned reddish vaginal mucosa, sometimes with extensive erosions or ulcerations and abundant yellowish discharge (without the fishy amine odour, typical of bacterial vaginosis). The pH is usually high. Symptoms can include burning, stinging and dyspareunia. The symptoms can last for long periods ...
Leukorrhea can be confirmed by finding >10 WBC per high-power field under a microscope when examining vaginal fluid. [6] Vaginal discharge is normal, and causes of change in discharge include infection, malignancy, and hormonal changes. It sometimes occurs before an adolescent female has her first period, and is considered a sign of puberty.
In women, urethritis can be diagnosed with a number of tests including: urine test, blood test, vaginal culture, cytoscopy, or a nucleic acid test. [18] Women will also have abdominal and pelvic exams to check for urethral discharge, and tenderness of the lower abdomen or urethra. [6]
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