Urethritis medical therapy

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Cafer Zorkun, M.D., Ph.D. [2]

Medical Therapy

Pharmacotherapy

A variety of drugs may be prescribed based on the cause of the patient's urethritis. Some examples of medications based on causes include:

• Clotrimazole (Mycelex) - Trichomonas
• Doxycycline (Vibramycin) - Chlamydia
• Fluconazole (Diflucan) - Monilial
• Metronidazole (Flagyl) - Trichomonas
• Nitrofurantoin - Bacterial Infection
• Nystatin (Mycostatin) - Monilial
• Co-trimoxazole, which is a combination of Sulfamethoxazole and Trimethoprim in a ratio of 5 to 1 (Septrin, Bactrim) - Bacterial Infection

Nongonococcal Urethritis Treatment Preferred Regimen ▸ Doxycycline 100 mg bid po x 7 days OR ▸Azithromycin 1 gm po as single dose Pregnancy ▸ Erythromycin 500 mg po qid x 7 days OR ▸Amoxicillin 500 mg po tid x 7 days Alternative Regimen ▸ Erythromycin 500 mg qid po x 7 days OR ▸Ofloxacin 300 mg q12h po x 7 days OR ▸Levofloxacin 500 mg q24h x 7 days Pregnancy ▸ Azithromycin 1 gm po single dose

Gonococcal Urethritis Treatment Preferred Regimen ▸ Ceftriaxone 250 mg IM x 1 dose PLUS ▸ Azithromycin 1 gm PO x 1 dose for 7 days OR ▸ Doxycycline 100 mg po q12h for 7 days Alternative Regimen ▸ Azithromycin 2 gm po x 1 dose OR Cephalosporines single dose ▸ Ceftizoxime 500 mg IM OR ▸ Cefotaxime 500 mg IM OR ▸ Cefoxitin 2 gm IM + Probenecid 1 gm po OR ▸ Cefixime 400 mg po PLUS ▸ Azithromycin 1 gm PO x 1 doseORDoxycycline 100 mg po q12h x 7 days OR ▸ SpectinomycinNUS 2 gm IM x 1 dose Failure of treatment† ▸ Ceftriaxone 500 mg IM x 1 dose PLUS ▸ Azithromycin 2 gm po x 1dose

Proper perineal hygiene should be stressed. This includes avoiding use of vaginal deodarant sprays and proper wiping after urination and bowel movements. Intercourse should be avoided until symptoms subside.