Male Urethritis Clinical Practice Guidelines (JAID/JSC, 2021)

Japanese Association for Infectious Diseases/Japanese Society of Chemotherapy

These are some of the highlights of the guidelines without analysis or commentary. For more information, go directly to the guidelines by clicking the link in the reference.

February 26, 2021

Clinical guidelines on the management of male urethritis and related disorders were published in January 2021 by the Japanese Association for Infectious Diseases (JAID) and the Japanese Society of Chemotherapy (JSC) in the Journal of Infection and Chemotherapy.[1]

Male gonococcal urethritis

As a first choice, administer an intravenous (IV) drip infusion of ceftriaxone (CTRX) 1 g, in a single dose.

As a second choice, administer an intramuscular (IM) injection of spectinomycin (SPCM) 2 g, in a single dose.

Gonococcal epididymitis

As a first choice, administer an IV drip infusion of CTRX 1 g once or twice daily, over 1-7 days. Modify the administration period according to the severity.

As a second choice, administer an IM injection of SPCM 2 g in a single dose. If the initial treatment is insufficient, administer an additional 2 g each in the bilateral gluteal regions for a total of 4 g, 3 days after the initial injection.

Chlamydial urethritis

Treatment includes the following:

  • Azithromycin (AZM) 1000 mg, administered orally in a single dose

  • Clarithromycin (CAM) 200 mg, administered orally twice a day for 1 week

  • Minocycline (MINO) 100 mg, administered orally twice a day for 1 week

  • Doxycycline (DOXY) 100 mg, administered orally twice a day for 1 week

  • Levofloxacin (LVFX) 500 mg, administered orally once a day for 1 week

  • Tosufloxacin (TFLX) 150 mg, administered orally twice a day for 1 week

  • Sitafloxacin (STFX) 100 mg, administered orally twice a day for 1 week

Non-chlamydial non-gonococcal urethritis

This can be treated with AZM 1000 mg, administered orally in a single dose

Patients who do not respond to this regimen or in whom Mycoplasma genitalium infection is strongly suspected can be treated with STFX 100 mg orally twice a day for 1 week.

Drug susceptibility testing should be used to select treatment if a culture reveals Neisseria meningitidis or Haemophilus influenzae alone.

For more information, please go to Urethritis and Epididymitis.

For more Clinical Practice Guidelines, please go to Guidelines.

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