Antimicrobials are generally the drug of choice for gonococcal and non-gonococcal infections. The CDC in 2015 suggests using a dual therapy that consists of two antimicrobials that have different mechanisms of action would be an effective treatment strategy for<unk>  and it could also potentially slow down antibiotic resistance. A variety of drugs may be prescribed based on the cause of<unk> : * Gonococcal<unk>  (caused by N. gonorrhoeae): The CDC recommends administering an injection dose of ceftriaxone 250 mg intramuscularly and oral dose of azithromycin 1g simultaneously. Cefixime 400 mg oral single dose can be used as an alternative if ceftriaxone is not available. * Non-gonococcal<unk>  (caused by Chlamydia trachomatis): The CDC recommends administering an oral single dose of azithromycin 1g or a 7-day course of doxycycline 100 mg orally twice daily.' * Alternative treatments can also be used when the above options are not available: * Erythromycin base 500 mg orally four times daily for 7 days * Erythromycin ethylsuccinate 800 mg orally four times daily for 7 days * Levofloxacin 500 mg orally once daily for 7 days * Ofloxacin 300 mg orally twice daily for 7 days Treatment for both gonococcal and non-gonococcal<unk>  is suggested to be given under direct observation in a clinic or healthcare facility in order to maximize compliance and effectiveness. For non-medication management, proper perineal hygiene should be stressed. This includes avoiding use of vaginal deodorant sprays and proper wiping after urination and bowel movements. Sexual intercourse should be avoided at least 7 days after completion of treatment (and until symptoms resolves, if present). Past and current sexual partners should also be assessed and treated. Individuals displaying persistence or recurrence of symptoms should be instructed for possible re-evaluation. Although there is no standard definition, persistent<unk>  is defined as<unk>  that has failed to display improvement within the first week of initial therapy. Additionally, recurrent<unk>  is defined as<unk>  reappearing within 6 weeks after a previous episode of non-gonococcal<unk> . If recurrent symptoms are supported by microscopic evidence of<unk> , then re-treatment is appropriate. The following treatment recommendations are limited and based on clinical experience, expert opinions and guidelines for recurrent or persistent non-gonococcal<unk> : * If doxycycline was prescribed as initial therapy, give azithromycin 500 mg or 1 gram for the first day, then give azithromycin 250 mg once daily for 4 days plus metronidazole 400 – 500 mg twice daily for 5 days * If azithromycin was prescribed as initial therapy, then give doxycycline 100 mg twice daily for 7 days plus metronidazole 400 – 500 mg twice daily for 5 – 7 days * Moxifloxacin 400 mg orally once daily for 7 – 14 days can be given with use of caution, if macrolide-resistant M. genitalium infection is demonstrated Appropriate treatment for these individuals may require further referral to a urologist if symptoms persist after initial treatment.
Urethritis
Urinary tract infection
Vaginitis
Oophoritis
Chondritis
Orchitis
Prostatitis
Salpingitis