In:
Sexually Transmitted Diseases, Ovid Technologies (Wolters Kluwer Health), Vol. 46, No. 10 ( 2019-10), p. 676-682
Abstract:
Standard counseling at nongonococcal urethritis (NGU) diagnosis includes advice to abstain from sex for at least 7 days and until symptoms resolve. Methods From December 2014 to July 2018, we enrolled men who have sex with men and received azithromycin (1 g) for NGU at the Public Health–Seattle and King County STD Clinic. Over 12 weeks of follow-up, participants reported daily urethral symptoms and sexual activity on web-based diaries. Nongonococcal urethritis was defined as urethral symptoms or visible urethral discharge plus 5 or greater polymorphonuclear leukocytes per high-power field. Time of symptom resolution was defined as the first of 5 consecutive asymptomatic days. Results Of 100 participants with NGU and no Chlamydia trachomatis (CT)/ Mycoplasma genitalium (MG) coinfection, 36 (36%), 22 (22%), and 42 (42%) had CT-NGU, MG-NGU, and non-CT/non-MG NGU, respectively. Among men with MG-NGU, 94% had a macrolide resistance mutation. For all etiologies, median time to symptom resolution after azithromycin was 7 days (95% confidence interval [CI], 5–9); 37% had symptoms lasting longer than 7 days. For men with CT-NGU, MG-NGU, and non-CT/non-MG NGU, median time to symptom resolution was 4 days (95% CI, 2–6; 16% 〉 7 days), undefined days (95% CI, 7 to undefined; 60% 〉 7 days), and 7 days (95% CI, 5–11; 46% 〉 7 days), respectively. Median time to first sexual activity (any type) was 12 days (95% CI, 11–17); it was 16 days (95% CI, 12–18) to first urethral sexual exposure. Twenty-seven percent did not avoid urethral exposure for the recommended period. Conclusions Counseling at NGU diagnosis should educate patients that symptoms may persist more than 7 days, particularly for non-CT NGU, and emphasize the rationale for the 7-day abstinence period.
Type of Medium:
Online Resource
ISSN:
1537-4521
,
0148-5717
DOI:
10.1097/OLQ.0000000000001040
Language:
English
Publisher:
Ovid Technologies (Wolters Kluwer Health)
Publication Date:
2019
detail.hit.zdb_id:
2055170-8
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