Specific Organisms and Therapeutic Regimens
Organism-specific therapeutic regimens for urethritis are provided below, including those for the following [1, 2, 3] :
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Neisseria gonorrhoeae
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Chlamydia trachomatis
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Trichomonas vaginalis
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Mycoplasma genitalium
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Ureaplasma urealyticum
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Mycoplasma hominis
Neisseria gonorrhoeae (gonococcal urethritis):
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Ceftriaxone 500 mg IM (1g in patients weighing ≥150 kg)
If ceftriaxone is not available:
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Gentamicin 240 mg IM in a single dose plus azithromycin 2 g PO in a single dose or
If patient has a severe cephalosporin allergy:
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Gentamicin 240 mg IM in a single dose plus azithromycin 2 g PO in a single dose
Chlamydia trachomatis:
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Doxycycline 100 mg PO BID for 7d or
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Azithromycin 1 g PO in a single dose or
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Levofloxacin 500 mg PO once daily for 7d
Mycoplasma genitalium
If macrolide sensitive:
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Doxycycline 100 mg PO BID for 7d, followed by azithromycin 1 g PO initial dose then 500 mg PO once daily for 3 additional days (2.5 g total)
If macrolide resistant:
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Doxycycline 100 mg PO BID for 7d followed by moxifloxacin 400 mg PO once daily for 7 d
If If M genitalium is detected by an approved nucleic acid amplification test (NAAT) but M genitalium resistance testing is not available:
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Doxycycline 100 mg PO BID for 7d , followed by moxifloxacin 400 mg PO once daily for 7d
Trichomonas vaginalis
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Metronidazole 500 mg PO BID 7d in women; 2 g PO in a single dose in men [5] or
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Tinidazole 2 g PO in a single dose (women and men)
Ureaplasma urealyticum:
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Doxycycline 100 mg PO BID for 7d or
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Azithromycin 1 g PO in a single dose
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
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