Infection of the urethra. Why?

Acute urethritis (infection of the urethra or tube through which urine exits), together with infection of the vagina and bladder, are associated with symptoms of frequency, urgency and painful urination. Vaginitis is excluded by pelvic examination and wet preparations. Cystitis is diagnosed by urine analysis and culture. Acute urethritis should be differentiated from chronic urethral syndrome, since the latter disorder is long lasting and can last for 3 or 6 months. Most cases of acute urethritis is caused by infection with chlamydia trachomatis or Neisseria gonorrhea. Other causes include trichomonas vaginalis and herpes simplex virus and rarely Gram-negative bacilli and Haemophilus species.

Detection of ureaplasma urealiticum itself is not an indication for treatment and routine culture for this organism is not indicated. Group B streptococcus and bacterial vaginosis does not cause urethritis.

The best treatment for these patients is doxycycline for 7 days, as the most common cause of urethritis, vaginitis and cystitis excluding the chlamydia trachomatis. Concomitant therapy with intramuscular ceftriaxone sodium is indicated when the status of gonorrhea infection is unknown in the presence of symptoms of urethritis or chlamydia trachomatis infection.

The sulfa is the primary mode of therapy for acute cystitis, but has little activity against gonorrhea or chlamydia.

 

 

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