{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T19:57:32Z","timestamp":1792612652391,"version":"4.5.0"},"reference-count":22,"publisher":"Scientific Scholar","content-domain":{"domain":["ijdvl.com"],"crossmark-restriction":true},"short-container-title":["Indian J Dermatol Venereol Leprol"],"abstract":"\n Background<\/jats:title>\n While syndromic management is widely used in low-resource settings due to its cost-effectiveness and ease of patient care, growing concerns of antimicrobial resistance (AMR) and potential overtreatment highlight the need for regular aetiological testing to monitor treatment appropriateness.<\/jats:p>\n <\/jats:sec>\n \n Aim<\/jats:title>\n To evaluate and compare syndromic management for reproductive tract infection for assessing treatment strategies.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n In a prospective study, 250 sexually active, non-pregnant women aged 18\u201350 years, presenting with symptoms of lower genital tract infections were recruited as part of a prospective study from urban clinics in Mumbai. Participants underwent clinical and gynaecological examination, and standard syndromic management was provided. Samples were collected prior to treatment for Nugent scoring,\n Candida<\/jats:italic>\n culture, and multiplex polymerase chain reaction (PCR) to detect sexually transmitted infections (STIs).\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n The mean age of participants was 32.5 \u00b1 6.6 years, with 51.2% (n=128) belonging to the upper-lower socioeconomic class. Vaginal discharge was the most common symptom (42%, n=105). Aetiological analysis identified causative agents in 90% (n=225) of cases, while 10% (n=25) showed no identifiable aetiology. The most prevalent pathogens were\n Ureaplasma parvum<\/jats:italic>\n (47.2%) and\n Candida<\/jats:italic>\n species (44.4%), followed by those causing bacterial vaginosis (39.2%). Among\n Candida<\/jats:italic>\n species,\n Candida albicans<\/jats:italic>\n (47.1%) and\n Candida krusei<\/jats:italic>\n (45.2%) were most common. In contrast,\n Chlamydia trachomatis<\/jats:italic>\n (3.2%) and\n Mycoplasma genitalium<\/jats:italic>\n (1.2%) were less prevalent, and\n Neisseria gonorrhoeae<\/jats:italic>\n was not detected. Syndromic management led to overtreatment rates exceeding 96% for these low-prevalence pathogens, raising concerns about AMR.\n <\/jats:p>\n <\/jats:sec>\n \n Limitations<\/jats:title>\n Since this study is bounded to urban community clinics, it limits the expansion to rural scene, and AMR tests were not conducted due to the fastidious nature of microbes in the study and implementation challenges in resource limiting settings.<\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n Syndromic management remains feasible in resource-limited settings; however, its limitations in addressing low-prevalence pathogens emphasises the need for periodic aetiological testing to improve diagnostic accuracy and guide appropriate treatment.<\/jats:p>\n 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Devashish","family":"Patil","sequence":"additional","affiliation":[{"name":"Department of Clinical Research, ICMR-National Institute for Research in Reproductive and Child Health (NIRRCH), Mumbai, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kimaya","family":"Mali","sequence":"additional","affiliation":[{"name":"Department of Obstetrics & Gynecology Seth G.S Medical College and KEM Hospital, Mumbai, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Niranjan","family":"Mayadeo","sequence":"additional","affiliation":[{"name":"Department of Obstetrics & Gynecology Seth G.S Medical College and KEM Hospital, Mumbai, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jyotsna Shatrughan","family":"Dwivedi","sequence":"additional","affiliation":[{"name":"Department of Obstetrics & Gynecology Seth G.S Medical College and KEM Hospital, Mumbai, Maharashtra, 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