Feature Article

Nongonococcal urethritis: management in general practice

Nina Wines, Linda Dayan



Nongonococcal urethritis (NGU) is a common sexually transmitted infection in men. Despite significant advances in the understanding of the aetiology and treatment of this disease over the last decade, it can still be difficult to diagnose and manage.

Key Points

  • Nongonococcal urethritis (NGU) is one of the most common sexually transmitted diseases (STDs) in young men; it is often asymptomatic.
  • Clinically it is impossible to differentiate Neisseria gonorrhoeae infection from Chlamydia trachomatis infection; all patients with suspected urethritis need formal testing for these organisms.
  • Most cases of NGU are not due to C. trachomatis.
  • All patients with NGU should be offered testing for other STDs.
  • For patients with uncomplicated C. trachomatis urethritis, azithromycin 1 g in a single dose is as effective as doxycycline 100 mg given twice daily for 7 to 10 days.