Therapeutic targets
- Improvement of the symptomatology
- Elimination of pathogens
- Partner management in non-gonorrheic urethritis, i.e., infected partners, if any, must be located and treated (contacts must be traced for 4 weeks).
Therapy recommendations
- For bacterial infection (antibiotic therapy):
- Acute urethritis: e.g., azithromycin or doxycycline (tetracycline).
- Gonococcal infection: without resistance testing ceftriaxome (cephalosporins); combined with azithromycin if patient adherence is unknown [see below Gonorrhea/Tripper].
- Chlamydia infection: doxycycline or azithromycin (macrolides) [see below Chlamydia infection].
- Mycoplasma genitalium: doxycycline (leads only to quantity reduction of the pathogen but not to eradication); azithromycin (high resistance rate; as an alternative: moxifloxacin / quinolone resistance is also known) [see below Mycoplasma].
- Recurrent urethritis: metronidazole (nitroimidazoleI in combination with erythromycin or azithromycin (macrolides).
- Acute urethritis: e.g., azithromycin or doxycycline (tetracycline).
- For viral urethritis: aciclovir (antiviral/ (drug that inhibits the action of viruses).
- In mycotic-related urethritis: fluconazole (antifungal / antifungal).
- See also under “Further therapy“.
