# Cervical disease (cervicitis, leucoplakia, old cervical tear) - Category: acute - Review status: reviewed (every claim checked against a document named on this page) - Sources: Egyptian National Drug Formulary - antimicrobial-2023.pdf, Azithromycin monograph (chapter PDF p268) · Egyptian National Drug Formulary - antimicrobial-2023.pdf, Doxycycline monograph (chapter PDF p297) · Egyptian National Drug Formulary - antimicrobial-2023.pdf, Metronidazole monograph (chapter PDF p307) - Verified date: 2026-08 ## Verified against - Egyptian National Drug Formulary - antimicrobial-2023.pdf, Azithromycin monograph (chapter PDF p268) - Egyptian National Drug Formulary - antimicrobial-2023.pdf, Doxycycline monograph (chapter PDF p297) - Egyptian National Drug Formulary - antimicrobial-2023.pdf, Metronidazole monograph (chapter PDF p307) ## Treatment metadata - Azithromycin — oral.solid - Doxycycline — oral.solid - Metronidazole — oral.solid ## Complete treatment card ```text CERVICAL DISEASE (CERVICITIS, LEUCOPLAKIA, OLD CERVICAL TEAR) Sources: Egyptian National Drug Formulary - antimicrobial-2023.pdf, Azithromycin monograph (chapter PDF p268) · Egyptian National Drug Formulary - antimicrobial-2023.pdf, Doxycycline monograph (chapter PDF p297) · Egyptian National Drug Formulary - antimicrobial-2023.pdf, Metronidazole monograph (chapter PDF p307) Review status: REVIEWED against the source listed above (2026-08) IS IT THIS? - reference only, to read alongside your own examination SYMPTOMS - what the patient reports (6) - Vaginal discharge that is purulent or mucopurulent [pus · vaginal discharge] - Bleeding between periods or after intercourse, with or without pain [abnormal uterine bleeding] - Overlaps vaginitis: pain during intercourse and vaginal itching [itching] - Burning on passing urine suggests the urethra is involved too [burning on passing urine] - Lower abdominal pain points towards pelvic inflammatory disease or endometritis [abdominal pain · lower abdominal pain] - As many as 80 in 100 have no symptoms at all SIGNS - what you find (7) - Pelvic and vaginal examination is needed whenever cervicitis is suspected - The classic findings are mucopurulent discharge at the os, or a cervix that bleeds on touch [bleeding] - A normal examination does not rule the infection out - Pinpoint red spots on the cervix, the strawberry appearance, suggest trichomonas - Blisters or ulcers on the cervix suggest herpes simplex [blisters] - Mycoplasma cervicitis is silent in many and so goes unrecognised - Cervical excitation, adnexal or abdominal tenderness and high fever mean the upper tract is involved [abdominal pain · abdominal tenderness · fever · pelvic pain] TESTS (12) - Take a detailed sexual history: partners, practices, contraception, protection, previous infections - Nucleic acid amplification is the most sensitive and specific test for chlamydia and gonorrhoea - That test runs on endocervical cells, vaginal fluid or urine - Look for trichomonas and bacterial vaginosis as well, since a vaginal infection may sit alongside - Where bacterial vaginosis coexists, it may itself be driving the inflammation - Saline microscopy, the amine whiff test and vaginal pH sort out yeast and bacterial vaginosis - For trichomonas use the amplification test, as microscopy catches only about half - Mycoplasma genitalium is present in 10 to 30 of every 100 cases and is hard to identify - Test for Mycoplasma genitalium when cervicitis or pelvic infection persists or returns - Herpes testing is not advised unless suspicion is high, since its value is unknown - Ureaplasma, Mycoplasma hominis and group B streptococcus culture are not routine - Think of group B streptococcus when the first tests are negative and nothing else explains it IF NOT THIS - what else fits (5) - Other sexually transmitted infections are likely to be present as well - If infection tests are negative, consider contact dermatitis or a systemic disease such as lichen planus - After the menopause, genitourinary syndrome of menopause can imitate it - That syndrome usually brings atrophic vulvovaginitis with dryness and painful intercourse - Very rarely a cancer elsewhere spreads to the cervix: thyroid, breast, bowel or stomach Source StatPearls "Cervicitis" - disease-level clinical article Status traced to the source above 1. AZITHROMYCIN [1st line] Adult 1 g orally as a single dose - Single dose Peds Paediatric dosing is specialist-set and is not reproduced here. AWaRe WATCH group - carries resistance cost. Egyptian EML 2025. Source Egyptian National Drug Formulary - antimicrobial-2023.pdf, Azithromycin monograph (chapter PDF p268) Why Single-dose azithromycin is the simplest, most compliance-friendly first-line agent for chlamydial cervicitis, directly matching the formulary's 'sexually transmitted infections' line. Caution Treats the infectious cervicitis component only - cervical leucoplakia and an old cervical tear are not infections and are not treated with antibiotics; biopsy leucoplakia to exclude dysplasia. Caution in significant hepatic impairment and in known QT prolongation. Postcoital/intermenstrual bleeding or foul-smelling discharge needs examination before treating as simple cervicitis. A purulent discharge, like a foul-smelling one, needs examination before it is treated as simple cervicitis. Egypt AZATRIBACT 250MG 6 CAPS. RIVA PHARMA S... 15.00 EGP (2.50/unit) AZOMYCIN 250MG 6 CAPS. PHARCO 25.20 EGP (4.20/unit) AZATRIBACT 500MG 3 CAPS. RIVA PHARMA S... 13.50 EGP (4.50/unit) ZITHROMAX 250MG 6 CAPS. PFIZER 79.00 EGP (13.17/unit) ZITHROPRO 500 MG 6 F.C. TABS. EVA PHARMA 103.00 EGP (17.17/unit) AZROLID 500 MG 3 F.C.TABS. AMRIYA 63.00 EGP (21.00/unit) DISTABCIN 250 MG 6 DISPERSIBLE TABS. EGPI 43.50 EGP DISTABCIN 500 MG 3 DISPERSIBLE TABS. EGPI 43.50 EGP ZITHRODOSE 100MG/5ML SUSP. 15ML EL-OBOUR > AV... 12.00 EGP -> ? strength differs, ? different route - not oral solid ZITHROPHATE 200MG/5ML SUSP. 15ML ORGANO PHARMA... 12.75 EGP -> ? strength differs, ? different route - not oral solid 2. DOXYCYCLINE [2nd line] Adult 100 to 200 mg orally per day, in 1 to 2 divided doses Peds Paediatric dosing is specialist-set and is not reproduced here; formulary notes use under 8 years should be reserved for severe, life-threatening infections. Source Egyptian National Drug Formulary - antimicrobial-2023.pdf, Doxycycline monograph (chapter PDF p297) Why Oral alternative to azithromycin for chlamydial cervicitis; the formulary gives only a general adult dosing range here rather than a cervicitis-specific line, so duration should follow standard clinical practice (typically about 7 days) rather than any number invented from this quote. Caution Take with plenty of water, remain upright afterward to avoid oesophageal irritation. Use of doxycycline in children <8 years should be reserved for severe, potentially life- threatening infections. Photosensitivity can occur, so advise sun protection. Egypt FARCODOXIN 100MG 10 CAPS. PHARCO 11.00 EGP (1.10/unit) DOXY M.R.100 MG 10 CAPS. ADWIA 12.00 EGP (1.20/unit) GRANUDOXY 100MG 10 F.C. TAB. GLOBAL NAPI P... 12.00 EGP (1.20/unit) DOXYDOX 100 MG 10 CAPS. EIPICO 23.00 EGP (2.30/unit) DOXYMYCIN 100 MG 10 CAPS. EL NILE. 30.00 EGP (3.00/unit) DOXYCOST 200MG 10 TABS. PENTA PHARMA 43.00 EGP (4.30/unit) TABOCINE 100MG 10 CAPS. TABUK PHARMAC... 46.00 EGP (4.60/unit) VIBRAMYCIN 100MG 10 CAPS. PFIZER 65.00 EGP (6.50/unit) 3. METRONIDAZOLE [add-on - not a substitute] Adult 500 mg orally twice daily x 7 days Peds Paediatric dosing is specialist-set and is not reproduced here. Source Egyptian National Drug Formulary - antimicrobial-2023.pdf, Metronidazole monograph (chapter PDF p307) Why Added when trichomoniasis or mixed anaerobic/trichomonal infection is suspected as a cause of the discharge/cervicitis alongside chlamydia and gonorrhea coverage. Caution Treat the sex partner simultaneously for trichomoniasis. Strictly avoid alcohol and propylene glycol-containing products during treatment and for 3 days (72 hours) after the last dose - Egyptian National Drug Formulary, Antimicrobial 2023. Contraindicated in pregnant patients (first trimester) with trichomoniasis. Avoid alcohol or propylene glycol-containing products during therapy or within 3 days of therapy discontinuation. Egypt TRICHOGYL 250 MG 20 TAB. EL NASR 4.35 EGP (0.22/unit) DUMOZOL 500MG 20 F.C. TABS. MINA PHARM > ... 7.00 EGP (0.35/unit) FLAGICURE 250MG 20 TAB. KAHIRA 7.00 EGP (0.35/unit) METRONIDAZOLE-MUP 250 MG 20 F.C. TABS. MUP 11.00 EGP (0.55/unit) METROZOLE 250MG 20 TAB. MEMPHIS 20.00 EGP (1.00/unit) TRICHOGYL 500MG 12 F.C.TAB. EL NASR 15.00 EGP (1.25/unit) GEDAZOLE 500MG 20 TAB. JEDCO INT. CO... 34.00 EGP (1.70/unit) METROGYPTON 500 MG 20 F.C. TABS. GYPTO PHARMA 34.00 EGP (1.70/unit) DUMOZOL 125MG/5ML SUSP. 125ML MINA PHARM > ... 5.75 EGP -> ? strength differs, ? different route - not oral solid METROZOLE 125MG/5ML SUSP. 120 ML MEMPHIS 19.50 EGP -> ? strength differs, ? different route - not oral solid Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy. ``` --- Dawaa Reference is a reference for prescribers, not a medical device, and does not replace clinical judgement. [Privacy policy](/privacy)