What medicine should I take for men's urethritis?

More and more men are suffering from urethritis, which is many times higher than that of women. This is because the physical constitution and physiological organ structure of men appear to be slightly more conservative than those of women, but in fact men do not pay much attention to hygiene issues, especially underwear is not changed frequently, and the reproductive system is not dried in time. These are all factors that lead to the occurrence of urethritis. Men with urethritis should follow several guiding principles in normal times. How to use medication correctly?

Medication

(I) Treatment

The treatment of UTI requires the rational use of antibiotics based on certain important clinical pharmacological principles. For superficial mucosal infections such as cystitis, urinary tract antibiotics are easy to reach effective concentrations, that is, easy to cure, and blood drug concentrations are relatively unimportant. Therefore, penicillin cannot be used for Escherichia coli and Proteus infections outside the urinary tract, but is effective for cystitis caused by these bacteria.

Similarly, tetracycline can reach effective antibacterial concentrations in the urinary tract but not in serum and tissues. It can be used to treat infections caused by resistant Gram-negative bacilli, including deep tissue infections, kidney and prostate infections. Similarly, the infected area also requires effective drug concentrations.

In addition, effective blood drug concentration is also beneficial, advocating the use of bactericidal agents rather than antibacterial agents or the combination of the two drugs, rather than single drug treatment. Whether these views are correct is still inconclusive, but in the experimental model of pyelonephritis, it has been confirmed that immediately reducing the concentration in the kidney and quickly obtaining effective antibacterial treatment are equally important for preventing renal scar formation and should be given special attention.

The purpose of treating UTI is to prevent or treat systemic septicemia, relieve symptoms, remove isolated infection foci, eliminate urinary tract pathogens from intestinal and vaginal flora, prevent long-term complications, and minimize costs, side effects, and the possibility of drug-resistant flora. Choosing different drugs to treat different UTIs can achieve the best results in achieving the above goals. Common treatments for urinary tract infections are as follows:

1. Acute uncomplicated cystitis in young women. For healthy multiparous women with symptomatic lower urinary tract infection (such as dysuria, frequent urination, urgency, nocturia, and discomfort above the symphysis pubis) but without symptoms and signs of vaginitis (foul vaginal discharge, vulvar itching, dyspareunia, only dysuria without frequent urination and vulvovaginitis), the following points should be noted in their treatment:

(1) Clear the infection of the superficial mucosa of the lower urinary tract.

(2) Eliminate urinary tract pathogens from the vagina and lower digestive tract.

To achieve this goal, short-term therapy with sulfamethoxazole/trimethoprim (SMZ-TMP) or quinolones can be used, both of which are superior to β-lactamases. Quinolones and trimethoprim (TMP) are present in high concentrations in vaginal secretions, exceeding the drug concentrations required to eliminate common Escherichia coli and other major urinary pathogens (except enterococci).

At the same time, the antimicrobial activity of these antibiotics has little effect on the anaerobic and microaerophilic flora that are resistant to the main uropathogens, which remain intact. In contrast, β-lactamase drugs, such as amoxicillin, can promote the proliferation of the uropathogen Escherichia coli in the vagina.

There are two short-term treatment regimens, a single-dose regimen and a 3-day regimen. There is no strong evidence that the 3-day regimen is superior to the single-dose regimen. These two regimens, such as sulfamethoxazole/trimethoprim (SMZ-TMP) or a quinolone (ciprofloxacin, ofloxacin, lomefloxacin, or norfloxacin), seem to be equally effective in treating female cystitis.

However, single-dose therapy to eliminate urinary tract pathogens from vaginal or intestinal flora is less effective than a 3-day regimen, resulting in earlier relapses, mainly because relapses due to the above pathogens are more common. Longer courses (>5 days) are used in healthy multiparous women with symptoms suggestive of cystitis, which are not only expensive but also have a high incidence of side effects (rash, fever, and gastrointestinal discomfort, especially with sulfamethoxazole/trimethoprim). There is no evidence that long-term treatment improves the cure rate of this particular UTI in vaginal candidal infections.