{ "schema_version": 1, "kind": "condition", "id": "vaginitis-nonspecific", "name": "Vaginitis (Non-specific / Atrophic)", "category": "infectious", "sources": "BASHH National Guideline for the Management of Vulvovaginal Candidiasis & Vaginitis 2019 · BASHH UK National Guideline for the Management of Bacterial Vaginosis 2012 · Dalacin Cream 2% (clindamycin vaginal) SmPC sections 4.2 and 4.4 (eMC product 1080) · Estriol 1 mg/g cream SmPC sections 4.2 and 4.4 (eMC product 5384) · NAMS Position Statement: Management of genitourinary syndrome of menopause 2020 · NICE Guideline NG23: Menopause: diagnosis and management 2015 · Dalacin Cream 2% (clindamycin vaginal) SmPC sections 4.1 & 4.2, https://www.medicines.org.uk/emc/product/1080/smpc · DailyMed CLEOCIN (clindamycin phosphate) vaginal ovule label, SetID 3db26227-208d-4fdd-8426-1d9be5cda9b4, https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=3db26227-208d-4fdd-8426-1d9be5cda9b4 · SmPC sections 4.1 and 4.2, https://www.medicines.org.uk/emc/product/5384/smpc", "review_status": "reviewed", "verified_against": "BASHH UK National Guideline for the Management of Bacterial Vaginosis 2012 · Dalacin Cream 2% (clindamycin vaginal) SmPC sections 4.1 & 4.2, https://www.medicines.org.uk/emc/product/1080/smpc · DailyMed CLEOCIN (clindamycin phosphate) vaginal ovule label, SetID 3db26227-208d-4fdd-8426-1d9be5cda9b4, https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=3db26227-208d-4fdd-8426-1d9be5cda9b4 · SmPC sections 4.1 and 4.2, https://www.medicines.org.uk/emc/product/5384/smpc · Vaginitis - disease-level clinical article (vaginitis-nonspecific-clinical.txt)", "verified_date": "2026-08", "treatments": [ { "id": 1866, "generic": "Estriol", "line": 1, "is_adjunct": false, "form": "vaginal", "strength_mg": 0.5, "adult_dose": "1 applicator-dose (0.5 g cream = 0.5 mg estriol) intravaginally daily for first 4 weeks, then taper to maintenance 1 applicator-dose twice weekly.", "adult_duration": "Initial 2-3 weeks daily, then ongoing twice weekly maintenance", "dose_source": "SmPC sections 4.1 and 4.2, https://www.medicines.org.uk/emc/product/5384/smpc", "rationale": "Topical vaginal estriol cream/pessaries are not registered in Egypt; oral estriol tablets (Ovestin 1 mg) exist but differ in systemic absorption and route.", "cautions": [ "First-line low-dose topical estrogen for atrophic vaginitis and genitourinary syndrome of menopause (GSM).", "Minimal systemic absorption; endometrial protection with progestogen is NOT required for local low-dose intravaginal estriol.", "Exclude endometrial hyperplasia, unexplained vaginal bleeding, and active hormone-dependent malignancies before starting treatment.", "Two different products and two different strengths: the cream is 1 mg/g and one applicatorful delivers 0.5 mg, the pessary is 0.03 mg. 0.05 mg is neither of them." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "No clinical trials to support use in children.", "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": null, "peds_doses": null, "brands": [ { "trade_name": "OVESTIN 1 MG 20 TAB", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "SEDICO > SCHERING PLOUGH", "price_egp": 11.1, "pack_count": 20, "unit_price": 0.55, "strength_mg": 1.0, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null } ], "condition_id": "vaginitis-nonspecific" }, { "id": 1867, "generic": "Metronidazole", "line": 1, "is_adjunct": false, "form": "oral.solid", "strength_mg": 500.0, "adult_dose": "400 mg orally twice daily for 7 days (or 0.75% vaginal gel once daily at bedtime for 5 days) for non-specific bacterial vaginitis / bacterial vaginosis", "adult_duration": "7 days oral (or 5 days vaginal)", "dose_source": "BASHH UK National Guideline for the Management of Bacterial Vaginosis 2012", "rationale": "Nitroimidazole antibiotic active against the anaerobic bacteria, including Gardnerella vaginalis, responsible for bacterial vaginosis, the most common cause of non-specific vaginal discharge; a first-line oral or topical treatment.", "cautions": [ "400 mg twice daily is the BASHH figure for bacterial vaginosis. 500 mg twice daily is the CDC one; both are in use, and the dose given here follows BASHH.", "Indicated when non-specific vaginitis presents with foul malodorous discharge, clue cells, or elevated pH (> 4.5) indicative of bacterial vaginosis.", "May cause metallic taste, nausea, and gastrointestinal discomfort.", "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." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "Paediatric dosing for bacterial vaginosis is not addressed in this BASHH adult guideline; specialist paediatric evaluation is required.", "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": null, "peds_doses": null, "brands": [ { "trade_name": "DUMOZOL 500MG 20 F.C. TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MINA PHARM > ALPHARMA-DENMARK", "price_egp": 7.0, "pack_count": 20, "unit_price": 0.35, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "ZOLGUARD 500MG 20 TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "UNIPHARMA CO. > UNIPHARMA", "price_egp": 9.0, "pack_count": 20, "unit_price": 0.45, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "NITROFECTAZOLE 500 MG 20 F.C. TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "GYPTO PHARMA", "price_egp": 10.5, "pack_count": 20, "unit_price": 0.53, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "FLAGICURE FORTE 500 MG 20 F.C. TAB", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "KAHIRA", "price_egp": 23.0, "pack_count": 20, "unit_price": 1.15, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "TRICHOGYL 500MG 12 F.C.TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EL NASR", "price_egp": 15.0, "pack_count": 12, "unit_price": 1.25, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "FLAGELLAT FORTE 500MG 20 F.C.TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MUP", "price_egp": 30.0, "pack_count": 20, "unit_price": 1.5, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "GEDAZOLE 500MG 20 TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "JEDCO INT. CO. FOR PHARMACEUTICALS", "price_egp": 34.0, "pack_count": 20, "unit_price": 1.7, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "METROGYPTON 500 MG 20 F.C. TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "GYPTO PHARMA", "price_egp": 34.0, "pack_count": 20, "unit_price": 1.7, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "DUMOZOL 125MG/5ML SUSP. 125ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MINA PHARM > ALPHARMA-DENMARK", "price_egp": 5.75, "pack_count": null, "unit_price": null, "strength_mg": 125.0, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null }, { "trade_name": "METROZOLE 125MG/5ML SUSP. 120 ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MEMPHIS", "price_egp": 19.5, "pack_count": null, "unit_price": null, "strength_mg": 125.0, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null } ], "condition_id": "vaginitis-nonspecific" }, { "id": 1869, "generic": "Referral & safety-netting (no drug therapy)", "line": 1, "is_adjunct": false, "form": null, "strength_mg": null, "adult_dose": null, "adult_duration": null, "dose_source": "Vaginitis - disease-level clinical article (vaginitis-nonspecific-clinical.txt)", "rationale": "Carries the referral criteria and warning signs for this condition, which apply whichever treatment is chosen.", "cautions": [ "RED FLAG - Bacterial vaginosis and trichomoniasis in pregnancy carry risks of preterm labor, low birth weight, and chorioamnionitis." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": null, "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": null, "peds_doses": null, "brands": [], "condition_id": "vaginitis-nonspecific" }, { "id": 1868, "generic": "Clindamycin", "line": 2, "is_adjunct": false, "form": "vaginal", "strength_mg": 100.0, "adult_dose": "Cream 2%: 1 applicatorful (5 g = 100 mg clindamycin) intravaginally at bedtime for 7 days (or 3 days). Ovules: 1 ovule (100 mg) intravaginally at bedtime for 3 days.", "adult_duration": "3-7 days", "dose_source": "Dalacin Cream 2% SmPC sections 4.1 & 4.2 (eMC product 1080, cream regimen) and DailyMed CLEOCIN clindamycin phosphate vaginal ovule label (ovule regimen), SetID 3db26227-208d-4fdd-8426-1d9be5cda9b4", "rationale": "Lincosamide antibiotic with anaerobic activity, used as a topical alternative to metronidazole for bacterial vaginosis in patients who are allergic to or fail metronidazole therapy.", "cautions": [ "Alternative treatment for non-specific bacterial vaginitis in patients allergic to metronidazole or failing metronidazole.", "Clindamycin vaginal cream weakens latex condoms and diaphragms for up to 72 hours after application.", "Not in the first trimester - there are no adequate studies. Second and third only where it is clearly needed.", "Expect thrush afterwards in a fair number of women: clearing the bacteria lets yeast take the space." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "Safety and efficacy in paediatric patients have not been established.", "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": null, "peds_doses": null, "brands": [ { "trade_name": "CHENAROMITA 100MG 3 VAGINAL OVULES", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "SEDICO > PEOPLE PHARMA", "price_egp": 14.0, "pack_count": null, "unit_price": null, "strength_mg": 100.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null } ], "condition_id": "vaginitis-nonspecific" } ] }