Urethritis Treatment & Management

  • Author: Martha K Terris, MD, FACS; Chief Editor: Edward David Kim, MD, FACS   more...
 
Updated: Aug 10, 2009
 

Medical Care

Symptoms of urethritis spontaneously resolve over time, regardless of treatment. Administer antibiotics to prevent morbidity and to reduce disease transmission to others. Treating sexual contacts also prevents reinfection of the index patient.

Antibiotic therapy should cover both gonococcal urethritis and nongonococcal urethritis (NGU). If concomitant treatment for NGU is not provided, the risk of postgonococcal urethritis is approximately 50%. The choice of antibiotics should be based on cost, adverse effects, effectiveness, and compliance. In most situations, optimal treatment is with single-dose therapy administered in the emergency department or the physician's office.

Next

Activity

  • Instruct the patient to refrain from intercourse until all partners are treated.
  • Educate the patient about always using barrier devices when engaging in intercourse with multiple partners.
  • Inform patients that infections can spread by orogenital or genitoanal intercourse, even in the absence of penovaginal intercourse.
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Contributor Information and Disclosures
Author

Martha K Terris, MD, FACS  Professor, Department of Surgery, Medical College of Georgia

Martha K Terris, MD, FACS is a member of the following medical societies: American Cancer Society, American College of Surgeons, American Institute of Ultrasound in Medicine, American Urological Association, New York Academy of Sciences, and Society of University Urologists

Disclosure: Nothing to disclose.

Coauthor(s)

Kamran P Sajadi, MD  Staff Physician, Division of Urology, Medical College of Georgia Health System

Kamran P Sajadi, MD is a member of the following medical societies: American Urological Association, Endourological Society, and National Association for Continence

Disclosure: Nothing to disclose.

Specialty Editor Board

Leonard Gabriel Gomella, MD, FACS  The Bernard W Godwin Professor of Prostate Cancer Chairman, Department of Urology, Associate Director of Clinical Affairs, Kimmel Cancer Center, Thomas Jefferson University

Leonard Gabriel Gomella, MD, FACS is a member of the following medical societies: American Association for Cancer Research, American College of Surgeons, American Medical Association, American Society for Laser Medicine and Surgery, American Urological Association, Sigma Xi, Society for Basic Urologic Research, Society of University Urologists, and Society of Urologic Oncology

Disclosure: GSK Consulting fee Consulting; Astra Zeneca Honoraria Speaking and teaching; Watson Pharmaceuticals Consulting fee Consulting

Francisco Talavera, PharmD, PhD  Senior Pharmacy Editor, eMedicine

Disclosure: eMedicine Salary Employment

J Stuart Wolf Jr, MD, FACS  David A Bloom Professor of Urology, Director of Division of Minimally Invasive Urology, Department of Urology, University of Michigan

J Stuart Wolf Jr, MD, FACS is a member of the following medical societies: American College of Surgeons, American Urological Association, Catholic Medical Association, Endourological Society, Society for Urology and Engineering, Society of Laparoendoscopic Surgeons, Society of University Urologists, and Society of Urologic Oncology

Disclosure: Terumo Corporation Consulting fee Consulting; Omeros Corporation Consulting fee Consulting

Chief Editor

Edward David Kim, MD, FACS  Professor of Surgery, Division of Urology, University of Tennessee Graduate School of Medicine; Consulting Staff, University of Tennessee Medical Center

Edward David Kim, MD, FACS is a member of the following medical societies: American College of Surgeons, American Society for Reproductive Medicine, American Society of Andrology, American Urological Association, and Tennessee Medical Association

Disclosure: Lilly Consulting fee Consulting; Astellas Consulting fee Speaking and teaching; Indevus Consulting fee Speaking and teaching

References
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  12. Jensen JS, Bradshaw CS, Tabrizi SN, Fairley CK, Hamasuna R. Azithromycin Treatment Failure in Mycoplasma genitalium-Positive Patients with Nongonococcal Urethritis Is Associated with Induced Macrolide Resistance. Clin Infect Dis. Dec 15 2008;47(12):1546-1553. [Medline].

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  16. Newman LM, Moran JS, Workowski KA. Update on the management of gonorrhea in adults in the United States. Clin Infect Dis. Apr 1 2007;44 Suppl 3:S84-101. [Medline].

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  18. [Guideline] Workowski KA, Levine WC. Selected topics from the Centers for Disease Control and Prevention Sexually Transmitted Diseases Treatment Guidelines 2002. HIV Clin Trials. Sep-Oct 2002;3(5):421-33. [Medline]. [Full Text].

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