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Can be classified as gonococcal or non-gonococcal urethritis (NGU). NGU is caused most commonly by Chlamydia trachomatis and Mycoplasma genitalium; however, it is common to not find any cause.
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First-pass urine (FPU) for Chlamydia and Gonorrhoea NAAT
If discharge, urethral swab for microscopy and culture
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Treat with doxycycline 100 mg (o) bd for 7 d while waiting for results
If N.Gonorrhoea detected, treat with ceftriaxone 500 mg IM and azithromycin 1 g (o) as a single dose
If tests are negative and symptoms persist, consider referral (depending on access) for first-pass urine NAAT testing for Mycoplasma genitalium, HSV and adenovirus
Female partners are at greater risk of PID and require assessment