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Treating Non-Gonococcal Urethritis: The Selection Of Antibiotics Is Crucial

Non-gonococcal urethritis is a sexually transmitted disease caused by pathogens other than gonococcus, mainly chlamydia trachomatis, and mycoplasma. Non-gonococcal urethritis shows symptoms of urethritis clinically, but gonococci cannot be found in the secretion, and there is no growth of gonococci in bacterial culture.


Non-gonococcal urethritis is a multifactorial syndrome, with pathogens such as chlamydia, mycoplasma, trichomonas, herpesviruses, Candida, etc. 30%~50% of non-gonococcal urethritis is related to chlamydia trachomatis, 20%~30% is ureaplasma urealyticum infections, and 10% is caused by trichomonas in the vagina, candida albicans, herpes simplex virus, mycoplasma genitalium, adenoviruses, bacilli, and other microorganisms.

Non-gonococcal urethritis in males is characterized by discomfort, itching, burning sensation, or stinging of the urethra, redness, and swelling of the urethra, and a severe and thin discharge of the urethra. Non-gonococcal urethritis in women is characterized by inflammation and erosion of the cervix, increased secretion, and a majority of lobulated white blood cells (more than 10 in each field at high magnification) in the cervical secretion. Itching of the vagina and external genitalia and discomfort in the lower abdomen are also symptoms of non-gonococcal urethritis.

The treatment of non-gonococcal urethritis is mainly based on antibiotics. Commonly used antibiotics include cephalosporins, quinolones, tetracyclines, azithromycin, fosfomycin, etc. These antibiotics have sound therapeutic effects on non-gonococcal urethritis. The treatment course of oral antibiotics for non-gonococcal urethritis is generally about two weeks. It can generally be cured only after the clinical symptoms have completely disappeared and the white blood cells in the urine routine have completely turned negative.

However, specific antibiotics should be selected based on the results of urine secretion culture and drug sensitivity tests, as well as the pharmacokinetic and pharmacodynamic characteristics of the drug. Taking the secretion from the urethral opening for bacterial culture is necessary.

If it is determined that the infection is caused by Mycoplasma and Chlamydia, the preferred treatment drug with better efficacy is macrolide antibiotics such as azithromycin, roxithromycin, and clarithromycin. Common bacterial infections are treated with cephalosporins, including cefixime, cefaclor, and cefprozil. Quinolone antibiotics such as levofloxacin hydrochloride, gatifloxacin and ciprofloxacin.

If left untreated, non-gonococcal urethritis usually has the following effects:

1. Patients will often suffer from the torment of illness. The typical symptoms of non-gonococcal urethritis are itching of the urethra, often accompanied by painful urination, urgency, and difficulty urinating, all of which bring great pain and harm to patients. Patients may experience burning, pain, and other symptoms in or near their genitals. After a while, they may develop erythema on their genitals, which can develop into painful blisters and often leave ulcers, posing a significant risk. Patients may also experience headaches, fever, and joint and muscle pain.

2. Complications may occur. If the patient is male, non-gonococcal urethritis may cause serious complications such as epididymitis, prostatitis, and infertility. For female patients, many of them have no symptoms. Generally speaking, it may cause serious diseases such as mucopurulent cervicitis, urethritis, acute pelvic inflammatory disease, and even infertility. This disease is often co-infected with other sexually transmitted diseases, which poses a significant risk to the patients.

3. Patients may also have severe psychological burdens. Non-gonococcal urethritis may also recur and be challenging to control, so patients often have a severe psychological burden. Patients often dare not engage in sexual activity with others and are afraid of cancer. Patients often lose patience and confidence in treatment, and their spirit gradually fades.

Non-gonococcal urethritis can cause a series of hazards. If patients experience related symptoms, they should seek medical attention promptly, identify the cause, and receive targeted treatments.

You may also be interested in:

Is Non-Gonococcal Urethritis considered sexually transmitted disease (STDs) for men or women?

Can Non-gonococcal Urethritis Be Tested Through Urinary Examination?

How Is Non-gonococcal Urethritis Transmitted?

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