Treatment of Vaginal Discharge

Diagnostic Criteria

Yellow-green, frothy discharge with malodor typically indicates trichomoniasis, which requires oral metronidazole 2g single dose or 500mg twice daily for 7 days, as recommended by the Centers for Disease Control and Prevention (CDC) 1, 2, 3
White, thick, "cottage cheese-like" discharge with pruritus indicates vulvovaginal candidiasis (VVC), which is treated with azole antifungals like clotrimazole, with a cure rate of 80-90% for uncomplicated candidiasis, as recommended by the CDC 1, 2, 3

The CDC recommends clotrimazole 1% cream 5g intravaginally for 7-14 days, or 100mg vaginal tablet for 7 days, or 500mg vaginal tablet as single dose for the treatment of VVC 1, 2
Metronidazole is the correct treatment for trichomoniasis, with a cure rate of 90-95%, and sex partners must be treated simultaneously, as recommended by the CDC 1, 2, 3

Wet mount microscopy should be performed to identify trichomonads, yeast, or clue cells, as recommended by the American Family Physician 1, 3
The American College of Obstetricians and Gynecologists (ACOG) and the CDC emphasize the importance of proper diagnosis and treatment of vaginal infections to prevent complications and reinfection 1, 2, 3