GENITOURINARY - STD, Urethritis, Nongonococcal

General statement: Confirm urethritis and rule out gonococcal or chlamydial infection. Patient should refer all sex partners within previous 60 days for evaluation and treatment.

 

 

Azithromycin

(Zithromax®)

Pregnancy: B; Lactation: Unk

 

Tabs: 250 mg    

Powder for Oral Suspension: 1 g    

 

 

Adolescents and Adult: 1 g ´ 1 dose.

 

Food: 1 g powder for oral suspension and tablet may be taken without regard to food.

 

Important side effects: Nausea, diarrhea, elevated LFTs.

 

 

Doxycycline

(Vibramycin®)

Generics available

Pregnancy: D; Lactation: Unsafe

Caps: 50 mg, 100 mg  

Tabs: 100 mg  

 

Adolescents and Adults: 100 mg twice daily for 7 days.

 

Food: May take with food if GI upset occurs. Take 1 hour before or 2 hours after antacids, iron, milk, or other dairy products. Take with full glass of water to prevent esophagitis.

 

Important side effects: Photosensitivity, use sunscreen. Esophagitis. May discolor fingernails.

 

 

Erythromycin Base*

Alternative

(E-Mycin®)

Generics available

Pregnancy: B; Lactation: Safe

Tabs: 250 mg, 500 mg  

Caps: 250 mg

 

 

Adolescents and Adults: 500 mg four times daily ´ 7 days (recommended) or, if gastrointestinal intolerance, 250 mg four times daily ´ 14 days.

 

Food: May take with or without meals. Take with food if causes GI upset.

 

Important side effects: GI upset, hepatitis, drug interactions.

 

Ofloxacin

Alternative

(Floxin®)

 

Adult: 300 mg twice daily for 7 days.

 

Food: Take on empty stomach. Do not take within 2 hours of antacids, magnesium, calcium, zinc, iron,

Pregnancy: C; Lactation: Unk

Tabs: 200 mg, 300 mg, 400 mg -    

 

aluminum, sucralfate, vitamins, or mineral supplements.

 

Important side effects: Nausea, photosensitivity, dizziness.

 

Reduce dose in renal disease

(CrCl <30 mL/min).

 

 

GENITOURINARY - STD, Urethritis, Nongonococcal, Recurrent, or Persistent

 

 

Metronidazole*

(Flagyl®)

Generics available

Pregnancy: B; Lactation: Unsafe

Tabs: 250 mg, 500 mg - <

*Use in conjunction with erythromycin.

 

Adolescents and Adult: 2 g ´ 1 dose.

 

Food: Administer on empty stomach unless GI upset occurs, then with food.

 

Important side effects: Dizziness, headache, confusion, seizures, nausea, metallic taste, insomnia, paresthesias.

 

Avoid alcohol.

 

 

Erythromycin Base*

(E-Mycin®)

Generics available

Pregnancy: B; Lactation: Safe

Tabs: 250 mg, 500 mg  

Caps: 250 mg  

*Use in conjunction with metronidazole.

 

Adolescents and Adults: 500 mg four times daily ´ 7 days.

 

Food: May take with or without meals. Take with food if causes GI upset.

 

Important side effects: GI upset, hepatitis, drug interactions.