NONGONOCOCCAL URETHRITIS (NGU): TREATMENT
The treatment of choice for bacterially caused NGU is antibiotics, most commonly doxycycline, azithromycin, erythromycin, or ofloxacin. The type of antibiotic chosen for initial treatment is the same for chlamydia as for the other bacterial causes of NGU. If herpes is thought to be the cause of the urethritis, then an antiherpes medication is used (see the section on herpes). If trichomonas is suspected, then metronidazole would be prescribed. All of these medications have possible side effects and interactions with other medications, and any treatment decision must take these factors into account. Ask your health care provider which medication is best for you.
Partners of a person diagnosed with NGU must also be evaluated and treated, whether or not the partner shows symptoms or evidence of infection on examination. All sexual contacts, generally within the past two months, must be treated. It is important not to resume sexual contact with a person until he or she has been completely treated and all symptoms have resolved in both partners.
If evidence of infection persists after treatment, another examination should be performed. If symptoms resolve, no follow-up examination is necessary. The medications are effective in about 95 percent of cases, but recurrence of infection occurs after successful treatment in about 10-20 percent of cases. Taking the medication incorrectly, having sexual contact with a partner who did not receive treatment, or having sex with a new, untested partner can all cause reinfection. If none of these possible explanations applies, a different antibiotic is usually prescribed. If the infection has progressed to the prostate, symptoms may persist despite treatment for NGU, and men whose symptoms do not resolve after treatment are usually evaluated for prostate infection.
Symptoms may occasionally persist even after several courses of antibiotics and eradication of the organism that caused the NGU. In this situation no further treatment is given, and the symptoms usually resolve on their own with time.
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