Male Urethritis Clinical Practice Guidelines (JAID/JSC, 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.

Any views expressed above are the author's own and do not necessarily reflect the views of WebMD or Medscape.

Cite this: Male Urethritis Clinical Practice Guidelines (JAID/JSC, 2021) - Medscape - Feb 26, 2021.

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