acute

Cervical disease (cervicitis, leucoplakia, old cervical tear)

Treatment options, dosing, cautions and Egyptian brands from the shipped Dawaa Reference card.

Evidence status

Checked against the sources named below

Sources3 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 against3 documents

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 date2026-08

Presentation reference

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

SourceStatPearls "Cervicitis" - disease-level clinical article

Presentation findings are traced to the source above.

AZITHROMYCIN

1st line

Formoral.solid

Adult dose and duration

1 g orally as a single dose - Single dose

Paediatric dose

Paediatric dosing is specialist-set and is not reproduced here.

AWaRe

WATCH group - carries resistance cost. Egyptian EML 2025.

Dose 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.

Cautions

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.

Egyptian brands

Egyptian brand	Manufacturer	Indicative price
AZATRIBACT 250MG 6 CAPS.	RIVA PHARMA S.A.E.	15.00 EGP (2.50/unit)
AZOMYCIN 250MG 6 CAPS.	PHARCO	25.20 EGP (4.20/unit)
AZATRIBACT 500MG 3 CAPS.	RIVA PHARMA S.A.E.	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? strength differs? different route - not oral solid	EL-OBOUR > AVERROES PHARMA-EGYPT	12.00 EGP
ZITHROPHATE 200MG/5ML SUSP. 15ML? strength differs? different route - not oral solid	ORGANO PHARMA > NOVELL PHARMA	12.75 EGP

DOXYCYCLINE

2nd line

Formoral.solid

Adult dose and duration

100 to 200 mg orally per day, in 1 to 2 divided doses

Paediatric dose

Paediatric dosing is specialist-set and is not reproduced here; formulary notes use under 8 years should be reserved for severe, life-threatening infections.

Dose 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.

Cautions

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.

Egyptian brands

Egyptian brand	Manufacturer	Indicative price
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 PHARMACEUTICALS > PIERRE FRANCE	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 PHARMACEUTICAL MANUFACTURING COMPANY > TABUK PHARMA	46.00 EGP (4.60/unit)
VIBRAMYCIN 100MG 10 CAPS.	PFIZER	65.00 EGP (6.50/unit)

METRONIDAZOLE

add-on - not a substitute

Formoral.solid

Adult dose and duration

500 mg orally twice daily x 7 days

Paediatric dose

Paediatric dosing is specialist-set and is not reproduced here.

Dose 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.

Cautions

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.

Egyptian brands

Egyptian brand	Manufacturer	Indicative price
TRICHOGYL 250 MG 20 TAB.	EL NASR	4.35 EGP (0.22/unit)
DUMOZOL 500MG 20 F.C. TABS.	MINA PHARM > ALPHARMA-DENMARK	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. FOR PHARMACEUTICALS	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? strength differs? different route - not oral solid	MINA PHARM > ALPHARMA-DENMARK	5.75 EGP
METROZOLE 125MG/5ML SUSP. 120 ML? strength differs? different route - not oral solid	MEMPHIS	19.50 EGP

Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy.