{ "schema_version": 1, "kind": "condition", "id": "dysuria", "name": "Dysuria (painful or burning urination)", "category": "infectious", "sources": "IDSA/ESCMID Cystitis 2011 · No dose - assessment step, no medicine given · Phenazopyridine Hydrochloride 100 mg tablets, FDA label sections Indications and Usage and Dosage and Administration (DailyMed set id 860f30ef-cfe3-4c35-8baf-dd788f02ac94) · Egyptian National Drug Formulary - Antimicrobial 2023 (doxycycline monograph) · Egyptian National Drug Formulary - Antimicrobial 2023 (ceftriaxone monograph)", "review_status": "reviewed", "verified_against": "IDSA/ESCMID Cystitis 2011 · Phenazopyridine Hydrochloride 100 mg tablets, FDA label sections Indications and Usage and Dosage and Administration (DailyMed set id 860f30ef-cfe3-4c35-8baf-dd788f02ac94) · No dose - assessment step, no medicine given · Egyptian National Drug Formulary - Antimicrobial 2023 (doxycycline monograph) · Egyptian National Drug Formulary - Antimicrobial 2023 (ceftriaxone monograph)", "verified_date": "2026-08", "treatments": [ { "id": 655, "generic": "No drug therapy in primary care (Assess first)", "line": 1, "is_adjunct": false, "form": null, "strength_mg": null, "adult_dose": "Dysuria is a symptom, not a diagnosis. In a non-pregnant woman with frequency and urgency and no vaginal discharge, cystitis is likely enough to treat on the history. Otherwise think again: vaginal discharge points to vaginitis or a sexually transmitted infection, flank pain and fever to pyelonephritis, and in a man dysuria is urethritis or prostatitis until proved otherwise. Ask about pregnancy every time.", "adult_duration": "Assess, then decide", "dose_source": "No dose - assessment step, no medicine given", "rationale": "Treating every dysuria as cystitis is how chlamydia is missed in young women and how pyelonephritis gets sent home with a short course of tablets.", "cautions": [ "Pregnancy changes the whole approach: asymptomatic bacteriuria is treated, a culture is always sent, and nitrofurantoin is avoided at term.", "Fever, rigors, flank pain or vomiting is pyelonephritis, not cystitis. That needs a culture and a different, longer antibiotic course.", "In a man, and in recurrent infection in a woman, send a urine culture rather than treating blind.", "Dysuria with a new sexual partner, urethral or vaginal discharge, or pelvic pain: test for chlamydia and gonorrhoea, and treat the partner.", "Visible blood in the urine that persists after the infection has been treated needs investigating for bladder cancer, particularly in a smoker over 45.", "Sterile pyuria - white cells with no growth - should raise chlamydia, and in Egypt also urinary tuberculosis and schistosomiasis.", "RED FLAG - Hematuria accompanying dysuria can signal urological obstruction from a stone or tumor and warrants further evaluation rather than empiric antibiotic treatment alone." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "Dysuria in an infant under 3 months, or with fever at any age, needs urgent assessment. Send the urine for culture before starting antibiotics, not after, and remember that urinary infection in a young child warrants thought about reflux.", "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": null, "peds_doses": null, "brands": [], "condition_id": "dysuria" }, { "id": 656, "generic": "Nitrofurantoin", "line": 1, "is_adjunct": false, "form": "oral.solid", "strength_mg": 100.0, "adult_dose": "100 mg BID (monohydrate/macrocrystals) or 50 mg QID", "adult_duration": "5 days", "dose_source": "IDSA/ESCMID Cystitis 2011", "rationale": "When the picture is uncomplicated cystitis, this is the first-line antibiotic: it concentrates in the urine, resistance remains low, and it does little to gut flora.", "cautions": [ "Contraindicated if eGFR < 45 mL/min.", "Take with food to improve absorption and lessen GI upset.", "It reaches therapeutic levels only in the bladder urine. It does not treat pyelonephritis or prostatitis.", "Avoid at term in pregnancy and in the neonate - haemolysis risk in G6PD deficiency.", "Pulmonary toxicity can occur on prolonged use, and urine turns brown." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "Specialist use only in children; 5-7 mg/kg/day divided QID", "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": null, "peds_doses": null, "brands": [ { "trade_name": "COLIFURAN 100 MG 20 TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "KAHIRA", "price_egp": 2.4, "pack_count": 20, "unit_price": 0.12, "strength_mg": 100.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "UVAMINE RETARD 100 MG 20 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MUP > ACINO", "price_egp": 47.0, "pack_count": 20, "unit_price": 2.35, "strength_mg": 100.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "MEPAFURAN 100 MG 20 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MEPACO", "price_egp": 54.0, "pack_count": 20, "unit_price": 2.7, "strength_mg": 100.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "MACROFURAN 100 MG 30 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "KAHIRA", "price_egp": 82.0, "pack_count": 30, "unit_price": 2.73, "strength_mg": 100.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null } ], "condition_id": "dysuria" }, { "id": 658, "generic": "Azithromycin", "line": 2, "is_adjunct": false, "form": "oral.solid", "strength_mg": null, "adult_dose": "1 g as a single dose", "adult_duration": null, "dose_source": "Egyptian National Drug Formulary - Antimicrobial 2023", "rationale": "Single-dose macrolide antibiotic coverage for nongonococcal urethritis causing male dysuria.", "cautions": [ "Rising macrolide resistance - reserve for penicillin allergy.", "The formulary's general paediatric regimen is 10-12 mg/kg on day 1 (max 500 mg) then 5-6 mg/kg once daily (max 250 mg). The flat five-day course here is the streptococcal-pharyngitis regimen and is deliberately different.", "Reserve for penicillin allergy due to macrolide resistance.", "QT prolongation can occur, so use caution with other QT-prolonging drugs." ], "peds_mgkg_low": 10.0, "peds_mgkg_high": 12.0, "peds_max_mg": 500.0, "peds_basis": "dose", "peds_unit": "mg", "peds_note": "Infants, Children, and Adolescents: Oral: 10 to 12 mg/kg/dose once on day 1 (usual maximum dose: 500 mg/dose) followed by 5 to 6 mg/kg once daily (usual maximum dose: 250 mg/dose) for remainder of treatment duration.", "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": null, "peds_doses": [ { "weight_kg": 10, "low_mg": 100, "high_mg": 120, "capped": false }, { "weight_kg": 20, "low_mg": 200, "high_mg": 240, "capped": false }, { "weight_kg": 30, "low_mg": 300, "high_mg": 360, "capped": false }, { "weight_kg": 40, "low_mg": 400, "high_mg": 480, "capped": false } ], "brands": [ { "trade_name": "AZATRIBACT 250MG 6 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "RIVA PHARMA S.A.E.", "price_egp": 15.0, "pack_count": 6, "unit_price": 2.5, "strength_mg": 250.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "AZOMYCIN 250MG 6 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "PHARCO", "price_egp": 25.2, "pack_count": 6, "unit_price": 4.2, "strength_mg": 250.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "AZATRIBACT 500MG 3 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "RIVA PHARMA S.A.E.", "price_egp": 13.5, "pack_count": 3, "unit_price": 4.5, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "ZITHROMAX 250MG 6 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "PFIZER", "price_egp": 79.0, "pack_count": 6, "unit_price": 13.17, "strength_mg": 250.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "ZITHROPRO 500 MG 6 F.C. TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EVA PHARMA", "price_egp": 103.0, "pack_count": 6, "unit_price": 17.17, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "AZROLID 500 MG 3 F.C.TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "AMRIYA", "price_egp": 63.0, "pack_count": 3, "unit_price": 21.0, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "DISTABCIN 250 MG 6 DISPERSIBLE TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EGPI", "price_egp": 43.5, "pack_count": null, "unit_price": null, "strength_mg": 250.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "DISTABCIN 500 MG 3 DISPERSIBLE TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EGPI", "price_egp": 43.5, "pack_count": null, "unit_price": null, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "ZITHRODOSE 100MG/5ML SUSP. 15ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EL-OBOUR > AVERROES PHARMA-EGYPT", "price_egp": 12.0, "pack_count": null, "unit_price": null, "strength_mg": 100.0, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null }, { "trade_name": "ZITHROPHATE 200MG/5ML SUSP. 15ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "ORGANO PHARMA > NOVELL PHARMA", "price_egp": 12.75, "pack_count": null, "unit_price": null, "strength_mg": 200.0, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null } ], "condition_id": "dysuria" }, { "id": 659, "generic": "Doxycycline", "line": 2, "is_adjunct": false, "form": "oral.solid", "strength_mg": 100.0, "adult_dose": "100 to 200 mg/day in 1 to 2 divided doses", "adult_duration": null, "dose_source": "Egyptian National Drug Formulary - Antimicrobial 2023 (doxycycline monograph)", "rationale": "Dysuria in men is commonly urethritis; the card carried azithromycin only, and the disease article names a tetracycline for the non-gonococcal cause.", "cautions": [ "Hypersensitivity to doxycycline, other tetracyclines, or any component of the formulation", "Use in children under 8 years should be reserved for severe, potentially life-threatening infections, or when better alternatives are unavailable.", "The ENDF gives a general dosage range, not a urethritis-specific course - the indication and the need for partner treatment come from the disease article." ], "peds_mgkg_low": 2.2, "peds_mgkg_high": 2.2, "peds_max_mg": 100.0, "peds_basis": "dose", "peds_unit": "mg", "peds_note": "ENDF general paediatric dosing: 2.2 mg/kg/dose every 12 hours, maximum 100 mg/dose.", "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": null, "peds_doses": [ { "weight_kg": 10, "low_mg": 22, "high_mg": 22, "capped": false }, { "weight_kg": 20, "low_mg": 44, "high_mg": 44, "capped": false }, { "weight_kg": 30, "low_mg": 66, "high_mg": 66, "capped": false }, { "weight_kg": 40, "low_mg": 88, "high_mg": 88, "capped": false } ], "brands": [ { "trade_name": "FARCODOXIN 100MG 10 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "PHARCO", "price_egp": 11.0, "pack_count": 10, "unit_price": 1.1, "strength_mg": 100.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "DOXY M.R.100 MG 10 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "ADWIA", "price_egp": 12.0, "pack_count": 10, "unit_price": 1.2, "strength_mg": 100.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "GRANUDOXY 100MG 10 F.C. TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "GLOBAL NAPI PHARMACEUTICALS > PIERRE FRANCE", "price_egp": 12.0, "pack_count": 10, "unit_price": 1.2, "strength_mg": 100.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "DOXYDOX 100 MG 10 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EIPICO", "price_egp": 23.0, "pack_count": 10, "unit_price": 2.3, "strength_mg": 100.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "DOXYMYCIN 100 MG 10 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EL NILE.", "price_egp": 30.0, "pack_count": 10, "unit_price": 3.0, "strength_mg": 100.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "TABOCINE 100MG 10 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "TABUK PHARMACEUTICAL MANUFACTURING COMPANY > TABUK PHARMA", "price_egp": 46.0, "pack_count": 10, "unit_price": 4.6, "strength_mg": 100.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "VIBRAMYCIN 100MG 10 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "PFIZER", "price_egp": 65.0, "pack_count": 10, "unit_price": 6.5, "strength_mg": 100.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null } ], "condition_id": "dysuria" }, { "id": 660, "generic": "Ceftriaxone", "line": 2, "is_adjunct": false, "form": "injection", "strength_mg": null, "adult_dose": "IV or IM: 1 to 2 g once daily, or divided twice daily", "adult_duration": null, "dose_source": "Egyptian National Drug Formulary - Antimicrobial 2023 (ceftriaxone monograph)", "rationale": "The app's own assessment text names urethritis as the presumed cause of dysuria in men, but the card carried no agent active against N. gonorrhoeae - nitrofurantoin is a cystitis drug and azithromycin covers the chlamydial partner organism. The ENDF lists uncomplicated gonococcal infection (cervical/urethral, rectal, and pharyngeal) as a ceftriaxone indication.", "cautions": [ "Hypersensitivity to ceftriaxone, any component of the formulation, or other cephalosporins", "Do not use in hyperbilirubinaemic neonates, particularly those who are premature, since ceftriaxone is reported to displace bilirubin from albumin binding sites.", "Do not give with intravenous calcium-containing solutions in neonates 28 days or younger.", "The ENDF gives a general adult dose and lists uncomplicated gonococcal infection as an indication, but states no gonorrhoea-specific figure - the indication comes from the disease article, the dose from the monograph's general adult range.", "Treat the sexual partner and test for co-infection; this is a disease-article instruction, not an ENDF dosing statement." ], "peds_mgkg_low": 50.0, "peds_mgkg_high": 75.0, "peds_max_mg": 1000.0, "peds_basis": "dose", "peds_unit": "mg", "peds_note": "ENDF: mild to moderate infection, 50 to 75 mg/kg/dose once daily; maximum daily dose 1,000 mg/day.", "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": null, "peds_doses": [ { "weight_kg": 10, "low_mg": 500, "high_mg": 750, "capped": false }, { "weight_kg": 20, "low_mg": 1000, "high_mg": 1000, "capped": true }, { "weight_kg": 30, "low_mg": 1000, "high_mg": 1000, "capped": true }, { "weight_kg": 40, "low_mg": 1000, "high_mg": 1000, "capped": true } ], "brands": [ { "trade_name": "CEFAXONE 250MG I.V. VIAL.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "PHARCO B", "price_egp": 15.0, "pack_count": null, "unit_price": null, "strength_mg": 250.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "CEFOTRIX 250MG I.V.VIAL (U.S.P.23)", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "UP PHARMA", "price_egp": 15.0, "pack_count": null, "unit_price": null, "strength_mg": 250.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "TRIXOMASH 500MG VIAL FOR I.V. INJ.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "RAMEDA > MASH PREMIERE", "price_egp": 16.5, "pack_count": null, "unit_price": null, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "TRIAXONE 500MG VIAL FOR I.M. INJ.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "TABUK PHARMACEUTICAL MANUFACTURING COMPANY > TABUK PHARMA", "price_egp": 36.0, "pack_count": null, "unit_price": null, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "WINTRIAXONE 1 GM PD. FOR I.M INJ.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "SANOFI", "price_egp": 48.0, "pack_count": null, "unit_price": null, "strength_mg": 1000.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "CEFTRIAXONE-SANDOZ 500 MG I.M. VIAL", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "PHARCO B > SANDOZ", "price_egp": 62.0, "pack_count": null, "unit_price": null, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "TRIAXONE 1 GM I.M. VIAL", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "TABUK PHARMACEUTICAL MANUFACTURING COMPANY > TABUK PHARMA", "price_egp": 106.0, "pack_count": null, "unit_price": null, "strength_mg": 1000.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "TRIAXONE 1 GM I.V VIAL", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "TABUK PHARMACEUTICAL MANUFACTURING COMPANY > TABUK PHARMA", "price_egp": 106.0, "pack_count": null, "unit_price": null, "strength_mg": 1000.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null } ], "condition_id": "dysuria" }, { "id": 657, "generic": "Phenazopyridine", "line": 2, "is_adjunct": true, "form": "oral.solid", "strength_mg": 100.0, "adult_dose": "200 mg (two 100 mg tablets) three times daily after meals", "adult_duration": "2 days maximum when given alongside an antibiotic", "dose_source": "Phenazopyridine Hydrochloride 100 mg tablets, FDA label sections Indications and Usage and Dosage and Administration (DailyMed set id 860f30ef-cfe3-4c35-8baf-dd788f02ac94)", "rationale": "A urinary mucosal analgesic that takes the edge off the burning in the first day or two while the antibiotic works. It treats nothing, and because it turns the urine bright orange it masks both the dipstick and visible blood - which is why the label caps it at two days.", "cautions": [ "Do not give in G6PD deficiency without deliberate thought - it can cause haemolysis, and G6PD deficiency is common enough in Egypt for this to matter in practice.", "Two days maximum alongside an antibiotic. The label states there is no evidence that longer adds anything.", "Warn the patient the urine will turn reddish-orange, and that it stains clothing and permanently stains soft contact lenses.", "A yellow tinge to the skin or the whites of the eyes means it is accumulating - stop it and check renal function.", "Avoid in renal impairment.", "It relieves the symptom and hides the signs. It is never a substitute for treating the infection, and never a reason to delay a culture." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "Not used in young children in primary care. The label's dosing applies to adults and children 12 years and over.", "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": null, "peds_doses": null, "brands": [ { "trade_name": "URISEPT 100 MG 20 SUGAR C.TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "KAHIRA", "price_egp": 5.0, "pack_count": null, "unit_price": null, "strength_mg": 100.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null } ], "condition_id": "dysuria" } ] }