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SEXUALLY TRANSMITTED DISEASES: RECURRENT OR PERSISTENT URETHRITIS

Patients with recurrent or persistent symptoms should be reevaluated for objective signs of urethritis. If re-exposure or poor compliance is suspected, retreatment with the original regimen is reasonable. Dual treatment for gonococcal and nongonococcal infection should also be considered if it was not already used. Retesting for C. trachomatis and N. gonorrhoeae should be done with caution, since nucleic acid amplification tests will remain positive up to 3 weeks after effective treatment. If persistent gonococcal infection is suspected, a culture should be performed instead of nucleic acid amplification so that antibiotic susceptibility can be assessed. expressmedscanada.com

If a compliant patient without re-exposure has persistent objective signs of infection, clinicians should test for Trichomonas vaginalis with cultures of first-void urine and intraurethral swab specimens. In such cases, presumptive treatment with metronidazole and erythromycin will eradicate both T. vaginalis and tetracycline-resistant U. urealyticum.

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Men's Health