Candida

High vaginal swab

Microscopy & culture

Identify on cervical smear

Treat if symptomatic

Intravaginal azole (e.g., Clotrimazole 500 mg stat)

If partner symptomatic

Bacterial vaginosis

High vaginal swab

Gram stain clue cells

PH >4.5

Treat if symptomatic or before gynaecology surgery or pregnant

Nil

Trichomonas

Microscopy and culture

Identify on cervical smear

Metronidazole 2 g PO stat

Treat partner

Screen for other STI

Chlamydia

Females: Vulvovaginal swab (Chlamydia swab rubbed around external urethra a couple of times then sliding about 5 cm into the vagina and rotating around the vaginal walls for 5-10 seconds (send for Chlamydia Nucleic Acid Amplification Test (NAAT))

Males: PCR from first void urine

Azithromycin 1 g PO stat

or

Doxycycline 100 mg BD 7 days

In pregnancy, give azithromycin 1 g PO stat. Give amoxicillin 500 mg TDS PO for 7 days if there are problems with azithromycin

Screen and treat partners

Screen for other STI

Gonorrhoea

Endocervical swab for culture

Urethral/anal swab

Throat swab

Ceftriaxone 500 mg IM and azithromycin 1 g PO stat

Screen and treat partners

Screen for other STI

Herpes simplex

Swab fluid from lesion in viral transport media

Aciclovir 400 mg TDS PO for 5-7 days

Catheterize if needed

Screen for other STI