Administration of sitafloxacin (200 mg/day) for | non-gonococcal urethritis

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 oon-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.