The two infections most commonly causing vaginal discharge are trichomonal and candidal vaginitis, both of which respond to well-established drugs.1 Once the infecting agent has been determined and the presence of gonorrhoea excluded by microscopical examination or culture, metronidazole is the drug of choice in Trichomonas vaginalis infection and nystatin in Candida albicans (monilia) infection. It is because treatment is often given empirically without the causative agent having been determined that many cases ‘fail’ to respond; other patients have difficulty in inserting vaginal pessaries.
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