Urethritis (non-gonorrhoea)

Micro-organism

Chlamydia trachomatis, Mycoplasma genitalium

Notes
  • Send exudates or pus for culture; MSSU and urine, endocervical and urethral swabs for chlamydia.
  • Send blood for culture if pyrexial.
  • If STD is suspected patients should be referred to Sexual Health Service (0345 337 9900) for partner notification and advice if required.
  • Consider immune deficiency and testing for HIV.
  • For more information refer to BASSH Guideline on Non-Gonococcal Urethritis (NGU)
First Line

Doxycycline 100mg oral 12 hourly for 7 days

OR

Azithromycin 1g oral stat then 500mg oral once daily for the next

2 days (total treatment is 3 days)

Persistent/ recurrent infection

If treated with doxycycline regimen first line:

Azithromycin 1g oral stat then 500mg oral once daily for the next

2 days (total treatment is 3 days)

plus

Metronidazole 400mg oral 12 hourly for 5 days

 

If treated with azithromycin first line:

Doxycycline 100mg oral 12 hourly for 7 days

plus

Metronidazole 400mg 12 hourly for 5 days