{ "schema_version": 1, "kind": "condition", "id": "urethritis-male", "name": "Male Urethritis (Acute)", "category": "infectious", "sources": "CDC Sexually Transmitted Infections Treatment Guidelines, 2021 (MMWR Recomm Rep 2021;70(4):1-187; PMC8344968), Gonococcal Infections - Uncomplicated Gonococcal Infection of the Cervix, Urethra, or Rectum (doses) and Urethritis (empiric treatment) · BASHH UK National Guideline for the Management of Urethritis 2018 · CDC Sexually Transmitted Infections Treatment Guidelines, 2021 (MMWR Recomm Rep 2021;70(4):1-187; PMC8344968), Nongonococcal Urethritis - Recommended Regimen · Egyptian National Drug Formulary - Antimicrobial 2023 (Version 1.0), cefixime monograph, Indications (\"Uncomplicated cervical/urethral gonorrhea\") and Dosage Regimen, Dosing: Adult, Usual dosage range · Urethritis in men - disease-level clinical article (urethritis-male-full.txt)", "review_status": "reviewed", "verified_against": "CDC Sexually Transmitted Infections Treatment Guidelines, 2021 (MMWR Recomm Rep 2021;70(4):1-187; PMC8344968), Gonococcal Infections - Uncomplicated Gonococcal Infection of the Cervix, Urethra, or Rectum (doses) and Urethritis (empiric treatment) · BASHH UK National Guideline for the Management of Urethritis 2018 · CDC Sexually Transmitted Infections Treatment Guidelines, 2021 (MMWR Recomm Rep 2021;70(4):1-187; PMC8344968), Nongonococcal Urethritis - Recommended Regimen · Egyptian National Drug Formulary - Antimicrobial 2023 (metronidazole monograph, trichomoniasis) · Urethritis in men - disease-level clinical article (urethritis-male-full.txt) · Egyptian National Drug Formulary - Antimicrobial 2023 (Version 1.0), cefixime monograph, Indications (\"Uncomplicated cervical/urethral gonorrhea\") and Dosage Regimen, Dosing: Adult, Usual dosage range", "verified_date": "2026-08", "treatments": [ { "id": 1869, "generic": "Ceftriaxone", "line": 1, "is_adjunct": false, "form": "injection", "strength_mg": 500.0, "adult_dose": "500 mg IM single dose PLUS Doxycycline 100 mg BID for 7 days for empiric treatment of acute male urethritis", "adult_duration": "single IM dose", "dose_source": "CDC Sexually Transmitted Infections Treatment Guidelines, 2021 (MMWR Recomm Rep 2021;70(4):1-187; PMC8344968), Gonococcal Infections - Uncomplicated Gonococcal Infection of the Cervix, Urethra, or Rectum (doses) and Urethritis (empiric treatment)", "rationale": "Third-generation cephalosporin that covers Neisseria gonorrhoeae, given together with doxycycline as empiric dual therapy for acute male urethritis before culture results are available, since gonococcal and chlamydial infection cannot be distinguished clinically.", "cautions": [ "Reconstitute with 1% lidocaine for IM injection to reduce pain.", "Notify and treat sex partners from past 60 days.", "Perform urethral swab or first-void urine NAAT for N. gonorrhoeae and C. trachomatis prior to therapy." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "Specialist pediatric adolescent medicine referral", "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": "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": "WINTRIAXONE 500 MG PD. FOR I.V INJ.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "SANOFI", "price_egp": 21.75, "pack_count": null, "unit_price": null, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "CEFAXONE 500MG I.V. VIAL", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "PHARCO B", "price_egp": 25.25, "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": "TRIAMERICAN 500 MG I.M. VIAL", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "RAMEDA > PAXAL", "price_egp": 46.0, "pack_count": null, "unit_price": null, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "EPICEPHIN 500 MG I.V. VIAL", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EIPICO", "price_egp": 47.0, "pack_count": null, "unit_price": null, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "CEFAXOTREZ 500 MG I.M. VIAL", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "RAMEDA > BOSTON CARE PHARMACEUTICALS", "price_egp": 63.0, "pack_count": null, "unit_price": null, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "CEFAXOTREZ 500 MG I.V. VIAL", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "RAMEDA > BOSTON CARE PHARMACEUTICALS", "price_egp": 63.0, "pack_count": null, "unit_price": null, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null } ], "condition_id": "urethritis-male" }, { "id": 1870, "generic": "Doxycycline", "line": 1, "is_adjunct": false, "form": "oral.solid", "strength_mg": 100.0, "adult_dose": "100 mg twice daily for 7 days co-administered with Ceftriaxone for Chlamydia coverage", "adult_duration": "7 days", "dose_source": "CDC Sexually Transmitted Infections Treatment Guidelines, 2021 (MMWR Recomm Rep 2021;70(4):1-187; PMC8344968), Nongonococcal Urethritis - Recommended Regimen", "rationale": "Tetracycline antibiotic that covers Chlamydia trachomatis and other atypical organisms, given alongside ceftriaxone to complete empiric dual coverage of acute male urethritis.", "cautions": [ "Advise completing full 7-day course even if discharge resolves.", "Abstain from sexual contact until 7 days after starting treatment and symptoms resolve." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "Not recommended under 8 years of age. The Egyptian National Drug Formulary - Antimicrobial 2023, doxycycline monograph, sets the same limit: below 8 years the drug should be held back for infections that are severe or life-threatening, or for cases where nothing better is available.", "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": "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": "urethritis-male" }, { "id": 1871, "generic": "Azithromycin", "line": 2, "is_adjunct": false, "form": "oral.solid", "strength_mg": 1000.0, "adult_dose": "1 g single oral dose (alternative when doxycycline is contraindicated or compliance is doubtful)", "adult_duration": "single dose", "dose_source": "BASHH UK National Guideline for the Management of Urethritis 2018", "rationale": "Macrolide alternative to doxycycline for chlamydial coverage in acute male urethritis, used when doxycycline is contraindicated or adherence is doubtful; it replaces only the chlamydia-covering half of therapy - ceftriaxone is still required for gonorrhoea.", "cautions": [ "This replaces the doxycycline half of the regimen, not the ceftriaxone. The injection covers gonorrhoea and is still needed.", "There are high rates of Mycoplasma genitalium macrolide resistance with single-dose azithromycin.", "Gastrointestinal side effects (nausea, abdominal cramps) are common." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "Specialist use only", "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": "AZIROWA 1000 MG 2 F.C. TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "AL ROWAD PHARMACEUTICAL INDUSTRIAL CO.", "price_egp": 44.0, "pack_count": 2, "unit_price": 22.0, "strength_mg": 1000.0, "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": "urethritis-male" }, { "id": 1872, "generic": "Metronidazole", "line": 2, "is_adjunct": false, "form": "oral.solid", "strength_mg": 500.0, "adult_dose": "500 mg twice daily", "adult_duration": "7 days", "dose_source": "Egyptian National Drug Formulary - Antimicrobial 2023 (metronidazole monograph, trichomoniasis)", "rationale": "The card covered gonococcal and chlamydial urethritis (ceftriaxone, doxycycline, azithromycin) and had nothing for Trichomonas vaginalis, which the disease article names as a cause in men. The article suggests a single dose; the ENDF's only trichomoniasis regimen is 500 mg twice daily for 7 days, explicitly for the index case and the sex partner, so that is the dose written here and the single-dose regimen is not.", "cautions": [ "Hypersensitivity to metronidazole, nitroimidazole derivatives, or any component of the formulation", "Pregnant patients (first trimester) with trichomoniasis", "Use of disulfiram within the past 2 weeks; use of alcohol or propylene glycol-containing products during therapy or within 3 days of therapy discontinuation", "Active neurological disorders; history of blood dyscrasia; hypothyroidism; hypoadrenalism" ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "Not applicable - a sexually transmitted infection in adult men.", "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": "DUMOZOL 500MG 20 F.C. TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MINA PHARM > ALPHARMA-DENMARK", "price_egp": 7.0, "pack_count": 20, "unit_price": 0.35, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "ZOLGUARD 500MG 20 TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "UNIPHARMA CO. > UNIPHARMA", "price_egp": 9.0, "pack_count": 20, "unit_price": 0.45, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "NITROFECTAZOLE 500 MG 20 F.C. TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "GYPTO PHARMA", "price_egp": 10.5, "pack_count": 20, "unit_price": 0.53, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "FLAGICURE FORTE 500 MG 20 F.C. TAB", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "KAHIRA", "price_egp": 23.0, "pack_count": 20, "unit_price": 1.15, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "TRICHOGYL 500MG 12 F.C.TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EL NASR", "price_egp": 15.0, "pack_count": 12, "unit_price": 1.25, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "FLAGELLAT FORTE 500MG 20 F.C.TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MUP", "price_egp": 30.0, "pack_count": 20, "unit_price": 1.5, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "GEDAZOLE 500MG 20 TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "JEDCO INT. CO. FOR PHARMACEUTICALS", "price_egp": 34.0, "pack_count": 20, "unit_price": 1.7, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "METROGYPTON 500 MG 20 F.C. TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "GYPTO PHARMA", "price_egp": 34.0, "pack_count": 20, "unit_price": 1.7, "strength_mg": 500.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "DUMOZOL 125MG/5ML SUSP. 125ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MINA PHARM > ALPHARMA-DENMARK", "price_egp": 5.75, "pack_count": null, "unit_price": null, "strength_mg": 125.0, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null }, { "trade_name": "METROZOLE 125MG/5ML SUSP. 120 ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MEMPHIS", "price_egp": 19.5, "pack_count": null, "unit_price": null, "strength_mg": 125.0, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null } ], "condition_id": "urethritis-male" }, { "id": 1873, "generic": "Cefixime", "line": 2, "is_adjunct": false, "form": "oral.solid", "strength_mg": 400.0, "adult_dose": "800 mg orally as a single dose", "adult_duration": "Single dose", "dose_source": "Urethritis in men - disease-level clinical article (urethritis-male-full.txt) for the adult single dose; the paediatric band is from Egyptian National Drug Formulary - Antimicrobial 2023 (cefixime monograph): \"Infants, Children, and Adolescents: Oral: 8 mg/kg/day divided every 12 to 24 hours; maximum daily dose: 400 mg/day\", the clinical article being adult-only.", "rationale": "The card's only gonococcal cover was intramuscular ceftriaxone. The disease article names cefixime among the alternative gonococcal regimens and states its dose in the same sentence - the alternatives it gives are a single 240 mg of gentamicin intramuscularly with 2 g of azithromycin by mouth, or 800 mg of cefixime by mouth - so one trusted document carries both claims. The Egyptian formulary also names uncomplicated cervical or urethral gonorrhoea in cefixime's indications, but gives only a general 400 mg daily range with no gonorrhoea-specific regimen; the international single dose therefore leads and the formulary's figure is quoted on the row. Gentamicin, the other alternative in the same sentence, remains refused: the ENDF's gentamicin indications name serious infections including urinary tract infections, but not gonorrhoea.", "cautions": [ "Hypersensitivity to cefixime, any component of the formulation, or other cephalosporins or penicillins", "The Egyptian formulary's figure is different and lower - its adult oral range is 400 mg a day, split across doses given 12 to 24 hours apart. It states no gonorrhoea-specific regimen and no duration.", "The disease article recommends cefixime only as an alternative, and in the same section it says the quinolones and the oral cephalosporins are not recommended, on the grounds of substantial bacterial resistance. Intramuscular ceftriaxone remains the first choice here.", "Test of cure 7 days after the dose when cefixime is used for gonococcal infection - the Egyptian formulary asks for it.", "CrCl 21 to 59 mL/minute: 260 mg once daily" ], "peds_mgkg_low": 8.0, "peds_mgkg_high": 8.0, "peds_max_mg": 400.0, "peds_basis": "day", "peds_unit": "mg", "peds_note": "ENDF, susceptible infection (mild to moderate), infants, children and adolescents: oral 8 mg/kg/day divided every 12 to 24 hours, maximum daily dose 400 mg. That is the formulary's general paediatric dose, not a paediatric gonorrhoea regimen.", "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": 80, "high_mg": 80, "capped": false }, { "weight_kg": 20, "low_mg": 160, "high_mg": 160, "capped": false }, { "weight_kg": 30, "low_mg": 240, "high_mg": 240, "capped": false }, { "weight_kg": 40, "low_mg": 320, "high_mg": 320, "capped": false } ], "brands": [ { "trade_name": "HEBIXIME 400MG 5 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "SHIFA MEDICAL PRODUCTS > GLORY MEDICAL", "price_egp": 60.0, "pack_count": 5, "unit_price": 12.0, "strength_mg": 400.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "XIMACEF 400MG 5 CAPSULE", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "SIGMA", "price_egp": 63.0, "pack_count": 5, "unit_price": 12.6, "strength_mg": 400.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "WIDEPREX 400 MG 5 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "BIOMED PHARMACEUTICALS", "price_egp": 104.0, "pack_count": 5, "unit_price": 20.8, "strength_mg": 400.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "SUPRAX 400 MG 5 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "KAHIRA > HIKMA PHARMA", "price_egp": 159.0, "pack_count": 5, "unit_price": 31.8, "strength_mg": 400.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "VIODRILNEX 100MG/5ML SUSP. 30ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "BADR PHARMA > HOCHSTER PHARMACEUTICAL INDUSTRIES", "price_egp": 21.5, "pack_count": null, "unit_price": null, "strength_mg": 100.0, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null }, { "trade_name": "CEFABRUM 100MG/5ML SUSP. 60ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "ALFACURE PHARMACEUTICALS", "price_egp": 27.0, "pack_count": null, "unit_price": null, "strength_mg": 100.0, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null } ], "condition_id": "urethritis-male" } ] }