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Non-Gonococcal Urethritis

Causes
1. Chlamydia trachomatis (35-45%)
2. Ureoplasma urealyticum (15-25%)
3. Other causes
  1. Trichomonas vaginalis
  2. Herpes Simplex Virus
  3. Idiopathic
Symptoms
1. Urethral discharge
2. Dysuria
Differential Diagnosis
1. Trichomonas
  1. Consider if no response to Azithromycin, Doxycycline
2. Chlamydia trachomatis
Management
1. First-Line
  1. Azithromycin 1 gram x1 dose
  2. Doxycycline 100 mg PO bid for 7 days
2. Persistent Urethritis
  1. Metronidazole 2 grams x1 dose and
  2. Erythromycin 500 mg PO qid for 7 days
References
1. Stamm (1995) JAMA 274:545

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This page was written by Scott Moses, MD. This page was last revised before 5/10/08, prior to consistent tracking of revision date. This page was last published on 6/1/2008. Please send comments and questions to the editor. Contact information may be found on the page About the Family Practice Notebook. These pages are best viewed with Microsoft Internet Explorer 6.0.