Treatment For Urethritis
The medications will aim to treat the underlying cause of urethritis and prevent infection spread. A nonsteroidal anti-inflammatory drug (NSAID) such as naproxen may be used to alleviate the discomfort. (11)
Pyridium, also known as phenazopyridine, is a medication that can be used to alleviate pain and reduce the need to excrete and the frequency of urination.
To increase adherence, the CDC recommends therapies that can be administered in a single dose. In addition, they recommend administering medication in the clinic and monitoring the initial dose. Any treatment for urethritis seeks to eliminate the infection’s source, prevent its spread, and alleviate symptoms. Depending on the infection’s source and severity, a variety of treatment options are available.
Those being treated for urethritis should abstain from sexual activity or use contraceptives. If an infection is the cause of the inflammation/swelling, your sexual partner will also need to be treated.
Patients with confirmed urethritis should receive concurrent treatment for gonococcal infections (gonorrhoea and chlamydia) unless test results are already known or rapid results can be obtained to limit treatment options.
Primary treatment for chlamydia consists of a single 1-gram dose of oral azithromycin (Zithromax) or 100 mg of oral doxycycline twice daily for seven days (for gonorrhoea), followed by either 125 mg of intramuscular ceftriaxone (Rocephin) or 400 mg of oral cefixime (Suprax).
Due to increasing resistance, fluoroquinolones are no longer recommended for the treatment of gonorrhoea on an empirical basis. Although fluoroquinolones may be effective if used inadvertently, a cure test is advised in these instances. Men with urethral symptoms but no objective signs or findings should await test results before receiving treatment. Exceptions include patients at high risk for STIs who are unlikely to return for test results and treatment.
It may be difficult to diagnose and treat men with persistent or recurrent urethral complaints who return for evaluation. A recurrent infection, often due to a lack of simultaneous partner treatment or reinfection by a new partner; an untreated infection, such as Mycoplasma, Ureaplasma, Trichomonas, HSV, Enterobacteriaceae, or adenovirus; a resistant organism; or a noninfectious cause are also considerations.
Azithromycin is the preferred treatment for infections caused by mycoplasma, ureaplasma, and chlamydia. Patients who test negative for these infections may find azithromycin beneficial. The emergence of azithromycin resistance in Mycoplasma has been documented, necessitating a prolonged or alternative treatment for persistent infections. In areas where trichomoniasis is prevalent, regular regimens may be supplemented with metronidazole (Flagyl) or tinidazole (Tindamax).
Precautionary Measures
If all infections have been ruled out, patients should use fragrance-free soaps, lubricants, and other products; increase their water consumption and avoid carbonated beverages; discontinue the use of spermicides; and reduce penile damage by masturbating or engaging in intimate relations less frequently or vigorously. Although unproven, dietary treatments are consistent with recommendations for other inflammatory urogenital conditions. Men with STI-caused urethritis should refrain from sexual activity for one week after beginning treatment.
