Specific Organisms and Therapeutic Regimens
Organism-specific therapeutic regimens for urethritis are provided below, including those for the following [1, 2, 3, 4] :
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Neisseria gonorrhoeae
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Chlamydia trachomatis
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Ureaplasma urealyticum
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Mycoplasma hominis
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Mycoplasma genitalium
Neisseria gonorrhoeae (gonococcal urethritis):
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Ceftriaxone 250 mg IM in a single dose (strongly preferred) plus
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Azithromycin 1 g PO in a single dose or
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Doxycycline 100 mg PO BID for 7 days (if allergic to azithromycin)
If ceftriaxone is not available:
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Azithromycin 1 g PO in a single dose or
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Doxycycline 100 mg PO BID for 7 days (if allergic to azithromycin)
If patient has a severe cephalosporin allergy:
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Azithromycin 2 g PO in a single dose plus
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Gemifloxacin 320 mg PO in a single dose or
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Gentamicin 240 mg IM in a single dose
Chlamydia trachomatis:
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Azithromycin 1 g PO in a single dose or
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Doxycycline 100 mg PO BID for 7d or
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Erythromycin base 500 mg PO QID for 7d or
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Erythromycin ethylsuccinate 800 mg PO QID for 7d or<
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Ofloxacin 300 mg PO BID for 7d or
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Levofloxacin 500 mg PO once daily for 7d
Ureaplasma urealyticum:
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Doxycycline 100 mg PO BID for 7d
Mycoplasma hominis:
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Azithromycin 1 g PO in a single dose or
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Doxycycline 100 mg PO BID for 7d or
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Erythromycin base 500 mg PO QID for 7d or
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Erythromycin ethylsuccinate 800 mg PO QID for 7d
Mycoplasma genitalium
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Azithromycin 1 g PO, one dose, followed by 500 mg PO daily for 3d
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Treatment failures should be re-treated with moxifloxacin 400 mg daily for 7d
Trichomonas vaginalis
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Metronidazole 2 g PO in a single dose or
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Tinidazole 2 g PO in a single dose
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