C. trachomatis negative and non-gonococcal urethritis

Question 1

Causes:

Answer 1

Mycoplasma genitilium
Ureaplasma urealyticum
Trichomonas vaginalis

Herpes simplex

Treponema pallidum

-UTIs
E.Coli
S. saprophyticus
Klebseilla pneumoniae
P. aeruginosa

Reiter's syndrome
Syphillis, 
Salmonella, 
Shigella, 
Campylobacter. 

Physical or chemical trauma

Question 2

Treatments for specific causes of NGU

Answer 2

Trichomonas vaginalis, and Gardenerella vaginalis- Metronidazole, 500mg orally, 2/day for 7 days.

HSV - Acyclovir 5% cream, Penciclovir 1% cream. Systemic acyclovir, 400mg/day

Empirical therapy for: Mycoplasma genitilium, Ureaplasma urealyticum

• Doxycycline 100mg every 12 hours 10-14 days (a tetracycline)
• Azithromycin, 1g single dose. (a macrolide, effective against both, alternatively erythromycin, macrolides also effective against campylobacter)

Emprical for E. coli or S. saprophyticus
Fluoroquinolones - Norfloxacin, ciprofloxacin
Ceftriaxone, or another 3rd gen ceph