Urethritis Organism-Specific Therapy

Organism-specific therapeutic regimens for urethritis are provided below, including those for the following ^{[1, 2, 3, 4]} :

• Neisseria gonorrhoeae
• Chlamydia trachomatis
• Ureaplasma urealyticum
• Mycoplasma hominis
• Mycoplasma genitalium

Neisseria gonorrhoeae (gonococcal urethritis):

• Ceftriaxone 250 mg IM in a single dose (strongly preferred) plus
• Azithromycin 1 g PO in a single dose or
• Doxycycline 100 mg PO BID for 7 days (if allergic to azithromycin)

If ceftriaxone is not available:

• Cefixime 400 mg PO in a single dose (patient should return in 1 week for a test-of-cure ^[5] )  plus
• Azithromycin 1 g PO in a single dose or
• Doxycycline 100 mg PO BID for 7 days  (if allergic to azithromycin)

If patient has a severe cephalosporin allergy:

• Azithromycin 2 g PO in a single dose plus
• Gemifloxacin 320 mg PO in a single dose or
• Gentamicin 240 mg IM in a single dose

Chlamydia trachomatis:

• Azithromycin 1 g PO in a single dose or
• Doxycycline 100 mg PO BID for 7d or
• Erythromycin base 500 mg PO QID for 7d or
• Erythromycin ethylsuccinate 800 mg PO QID for 7d or<
• Ofloxacin 300 mg PO BID for 7d or
• Levofloxacin 500 mg PO once daily for 7d

Ureaplasma urealyticum:

• Doxycycline 100 mg PO BID for 7d

Mycoplasma hominis:

• Azithromycin 1 g PO in a single dose or
• Doxycycline 100 mg PO BID for 7d or
• Erythromycin base 500 mg PO QID for 7d or
• Erythromycin ethylsuccinate 800 mg PO QID for 7d

Mycoplasma genitalium

• Azithromycin 1 g PO, one dose, followed by 500 mg PO daily for 3d
• Treatment failures should be re-treated with moxifloxacin 400 mg daily for 7d

Trichomonas vaginalis

• Metronidazole 2 g PO in a single dose or
• Tinidazole 2 g PO in a single dose