Template:Male urethritis treatment: Difference between revisions

Latest revision as of 18:58, 23 December 2020

Uncomplicated Infection

Treatment to cover both gonorrhea and chlamydia Typically, treatment for both gonorrhea and chlamydia is indicated, if one entity is suspected.

Standard

Gonorrhea
- Ceftriaxone IM x 1
  - 500 mg, if weight <150 kg
  - 1 g, if weight ≥150 kg
Chlamydia
- Doxycycline 100 mg PO BID x 7 days

Ceftriaxone contraindicated

Gonorrhea
- Gentamicin 240 mg IM x 1 PLUS azithromycin 2 g PO x 1, OR
- Cefixime 800 mg PO x 1
Chlamydia^
- Doxycycline 100 mg PO BID x 7 days

^Additional chlamydia coverage only needed if treated with cefixime only

Partner Treatment

Gonorrhea
- Cefixime 800mg PO x 1
Chlamydia
- Nonpregnant: doxycycline 100mg PO BID x 7 days, OR
- Pregnant: azithromycin 1g PO x 1

Recurrent or Persistent

Target M. genitalium

Moxifloxacin 400 mg daily x 7 days

Consider coverage of trichomonas, among men who have sex with women

Metronidazole 2 gm PO x 1, OR
Tinidazole 2 gm PO x 1

@@ Line 1: / Line 1: @@
+====Uncomplicated Infection====
 ''Treatment to cover both [[gonorrhea]] and [[chlamydia]]''
-====Uncomplicated Infection====
+''Typically, treatment for '''both''' gonorrhea and chlamydia is indicated, if one entity is suspected.''<br>
-*[[Ceftriaxone]] 250mg IM once, '''PLUS'''
+<br>
-**[[Azithromycin]] 1g PO once '''OR'''
+<u>Standard</u><br>
-**[[Doxycycline]] 100mg PO BID x 7 days
+*Gonorrhea
+**[[Ceftriaxone]] IM x 1
+***500 mg, if weight <150 kg
+***1 g, if weight ≥150 kg
+*Chlamydia
+**[[Doxycycline]] 100 mg PO BID x 7 days
+<br>
+<u>Ceftriaxone contraindicated</u><br>
+*Gonorrhea
+**[[Gentamicin]] 240 mg IM x 1 '''PLUS''' [[azithromycin]] 2 g PO x 1, '''OR'''
+**[[Cefixime]] 800 mg PO x 1
+*Chlamydia^
+**[[Doxycycline]] 100 mg PO BID x 7 days
-====Cephalosporin Allergy====
+^Additional chlamydia coverage only needed if treated with cefixime only
-*[[Azithromycin]] 2g PO once, '''PLUS'''
-**[[Gentamicin]] 240mg IM once<ref>[http://www.cdc.gov/std/tg2015/ CDC: 2015 Sexually Transmitted Diseases Treatment Guidelines]</ref>
-**In theory this high dose macrolide will provide treatment for both [[GC]] and [[Chlamydia]]
-====Partner treatment====
+====Partner Treatment====
-*[[Cefixime]] 400mg PO once, '''PLUS'''
+*Gonorrhea
-**[[Azithromycin]] 1g PO once, '''OR'''
+**[[Cefixime]] 800mg PO x 1
-**[[Doxycycline]] 100mg PO BID x 7 days
+*Chlamydia
+**Nonpregnant: [[doxycycline]] 100mg PO BID x 7 days, '''OR'''
+**Pregnant: [[azithromycin]] 1g PO x 1
 ====Recurrent or Persistent====
@@ Line 19: / Line 32: @@
 *[[Moxifloxacin]] 400 mg daily x 7 days
-''Consider coverage of [[T. vaginalis]], among men who have sex with women''
+''Consider coverage of [[trichomonas]], among men who have sex with women''
-*Metronidazole 2 gm PO x 1, '''OR'''
+*[[Metronidazole]] 2 gm PO x 1, '''OR'''
-*Tinidazole 2 gm PO x 1
+*[[Tinidazole]] 2 gm PO x 1