10 days Doxycycline and azithromycin have been shown to be equally efficacious. The single dose regime of azithromycin may improve compliance. A diagnosis of persistent or recurrent NSU is based on persisting PMNLs on a gram stained urethral smear, NOT on symptoms. If there is no evidence of persisting PMNLs, patients can be strongly reassured and they should not be treated with further courses of antibiotics. If the diagnosis is confirmed, there is no consensus regarding treatment.
Reassurance is recommended in both situations.
All sexual partners at risk should be assessed and offered treatment. This is to prevent symptomatic disease, reinfection and sequelae of infection. Female partners should be offered the same treatment regime as outlined above. It is unknown how long NSU can be carried in an asymptomatic individual. Follow-up of partner notification, testing and treatment.