How are persistent symptoms of urethritis managed?

Updated: Dec 12, 2018
  • Author: Martha K Terris, MD, FACS; Chief Editor: Edward David Kim, MD, FACS  more...
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Answer

Patients with persistent symptoms should be reevaluated.  In patients with a repeat diagnosis of NGU after treatment with doxycycline, the most common organism is M. genitalium.  Men who fail a treatment regimen of doxycycline should be treated with azithromycin 1 g orally in a single dose.  Men who fail this regimen should be treated with moxifloxacin 400 mg once daily for 7 days, as studies have shown this dosing is highly effective against M. genitalium.  [9]

T. vaginalis infection should be considered in heterosexual patients with persistent symptoms.  In regions where T. vaginalis is prevalent, patients with urethritis should be treated empirically with metronidazole 2 g orally in a single dose or tinidazole 2 g orally in a single dose.  [9]


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