NGU Flashcards
What % NGU is due to CT?
11-50%
What % NGU is due to M.gen?
6-50%
% of NGU with dual CT and M.gen infection
10%
Diagnosis in service where microscopy is not available?
- The presence of a mucopurulent or purulent urethral
discharge on examination. - on a leucocyte esterase dipstick on an FPU
specimen (see above).
60,61 - The presence of threads in a FPU specimen.
Threads may be physiological e.g. semen
How long does it take for inflammation for NGU to resolve?
detectable inflammation may
persist for an unknown length of time even when the
putative organism has been eliminated
Gene mutations causing m.gen resistance
gyrA and parC genes can occur
with a prevalence of 10% in Japan
Treatment for NGU
Doxycycline 100mg bd 7/7 (works in 95% of CT+ve patients)
or
azithromycin 1g stat
Treatment in NGU that is M.gen +ve
azithromycin 500mg stat then 250mg for 4 days
PN for NGU
4 Weeks (however evidence is not robust)
Treatment of partners for NGU?
No evidence of treatment benefit for CT-VE NGU however, if microscopy +ve to treat with doxycycline for 7days or 1g azithromycin
%Perisistent NGU (when symptoms do not resolve after treatment)
15-25%
What is the definition of recurrent NGU?
symptoms returning after 30-90 days of treatment
Next steps in DIAGNOSIS OF persistent NGU
Only perform a Gram-stained urethral smear in men
who are symptomatic.
. For those patients with confirmed chlamydia at initial
presentation please refer to the BASHH chlamydia guideline for advice on repeat NAAT
testing.
. Consider testing for T. vaginalis using a NAAT if
available.
. Consider testing for M. genitalium
Treatment for persistent NGU
Azithromycin 500mg stat then 250 mg daily for the
next 4 days plus Metronidazole 400 mg twice
daily for 5 days
OR
Moxifloxacin 400 mg orally once daily for 10–14
days plus Metronidazole 400 mg twice
daily for 5 days
Options for persistent NGU
Moxifloxacin 400mg OD for 7-14 days
Erythromycin 500mg ads for 3/52
clarithroymcin BD for 3/52
