Treatment for Leukorrhea

Diagnostic Approach

The Centers for Disease Control and Prevention recommends performing microscopic examination of vaginal discharge to identify leukorrhea (>10 WBC per high power field) and testing for Chlamydia trachomatis and Neisseria gonorrhoeae using nucleic acid amplification tests (NAAT) 1

The Centers for Disease Control and Prevention recommends Metronidazole 500 mg orally twice daily for 7 days, OR Metronidazole gel 0.75%, one full applicator (5 g) intravaginally, once daily for 5 days, OR Clindamycin cream 2%, one full applicator (5 g) intravaginally at bedtime for 7 days for bacterial vaginosis 1
The Centers for Disease Control and Prevention recommends Ceftriaxone 250 mg IM in a single dose PLUS Doxycycline 100 mg orally twice daily for 10 days for cervicitis/mucopurulent cervicitis in high-risk populations 1, 2
The Centers for Disease Control and Prevention recommends Metronidazole 2 g orally in a single dose, OR Tinidazole 2 g orally in a single dose for trichomoniasis 1

The Centers for Disease Control and Prevention recommends that sexual partners of patients with STI-related leukorrhea should be referred for evaluation and treatment, and that partners of patients with chlamydia or gonorrhea should be treated if sexual contact occurred within 60 days preceding symptom onset 1, 3

The Centers for Disease Control and Prevention recommends reevaluation if symptoms persist despite appropriate treatment, and consideration of alternative diagnoses or resistant organisms if no improvement occurs 1

The Centers for Disease Control and Prevention recommends that HIV-positive patients with cervicitis should receive the same treatment as HIV-negative patients 1, 2

The Centers for Disease Control and Prevention recommends avoiding reliance on patient-reported symptoms without microscopic confirmation to prevent misdiagnosis, and evaluating sexual partners to prevent reinfection 1, 3
The American Gastroenterological Association recommends avoiding overuse of corticosteroid preparations for symptomatic relief as prolonged use may be harmful 4