STI-related Urethral Discharge in Males

exp date isn't null, but text field is

Causes
Neisseria gonorrhoea (Gonococcal urethrits)
Chlamydia trachomatis (Non-gonococcal urethritis)

Mycoplasma genitalum

Symptoms

  • Urethral discharge
  • Dysuria or discomfort on urination

Signs

  • Urethral discharge

Note: Gentle milking of the urethra may reveal the discharge if it is not initially visible. In uncircumcised males, check that the discharge is coming from the urethral opening and not from the glans penis. 

Investigations

  • Urethral swab culture and sensitivity (if available)

TreatmentTreatment Objectives

  • To treat gonorrhoea and chlamydia urethritis simultaneously
  • To prevent further transmission to sexual partners.
  • To treat both partners simultaneously as much as possible
  • To prevent development of complications and sequelae
  • To reduce risk of HIV infection

Non-pharmacological treatment

  • None

Pharmacological Treatment

Evidence Rating: [C]

For Gonorrhoea

  • Ceftriaxone, IM, 250 mg stat

Or

  • Cefixime, oral, 400 mg stat

Or

  • Ciprofloxacin, oral, 500 mg stat

AND

For Chlamydia and Mycoplasma:

  • Doxycycline, oral, 100 mg 12 hourly for 7 days

Or

  • Tetracycline, oral, 500 mg 6 hourly for 7 days

Or

  • Erythromycin, oral, 500 mg 6 hourly for 7 days

Or

  • Azithromycin, oral, 1 g stat.