Vol.68 No.2 March 2020
Administration of sitafloxacin (200 mg/day) for non-gonococcal urethritis
1)Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata, Kita-ku, Okayama, Okayama, Japan
Department of Urology, Tokyo Women's Medical University Hospital
2)Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
Abstract
Male urethritis is a common disease encountered by clinicians, and at the initial visit to an outpatient clinic, male urethritis is diagnosed as gonococcal urethritis or non-gonococcal urethritis (NGU) and treated with antimicrobial agents. In patients with NGU, Chlamydia trachomatis is the most common pathogen; however, examination for pathogens other than Neisseria gonorrhoeae and C. trachomatis is not approved by insurance providers in Japan. In general, diagnosis of chlamydial/non-chlamydial urethritis is made after first-line antimicrobial administration to patients with NGU. Clinicians should administer second-line treatment for non-gonococcal or treatment-refractory urethritis cases in which Mycoplasma genitalium or other drug-resistant pathogens are likely. According to Japanese guidelines, sitafloxacin (STFX) is recommended as the first-line drug for chlamydial urethritis and as the second-line regimen for non-chlamydial NGU. Randomized controlled trials in Japan have reported superior outcomes with STFX as compared to azithromycin (AZM) in patients with NGU. Thus, although AZM is the first-line therapy of choice for NGU, including non-chlamydial NGU, STFX should be used not only for treatment-refractory patients, but also as first-line therapy for selected cases of NGU.
Key word
non-gonococcal urethritis, Mycoplasma genitalium, sitafloxacin
Received
April 9, 2018
Accepted
October 21, 2019
Jpn. J. Chemother. 68 (2): 181-185, 2020
