[Urethritis-A practical update].

backgroundPenile urethritis is a common medical condition, usually caused by sexually transmitted pathogens such as Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG) or Mycoplasma genitalium (MG). Although the causative pathogens cannot be reliably distinguished based on the clinical presentation alone, symptom-oriented empirical antibiotic therapy is often administered in practical care. MATERIAL AND

methodsThis is a summary of the recommendations from the S3 guidelines on the management of male adolescents and adults with symptoms of urethritis. The development of the guidelines was funded by the Innovation Committee of the Federal Joint Committee (Innovationsausschuss des Gemeinsamen Bundesausschusses, G‑BA; grant number 01VSF21021).

resultsThe guidelines present a symptom-oriented, evidence-based approach for suspected penile urethritis, considering pathogen epidemiology and possible coinfections and contains a flowchart for clinical management. This includes criteria for or against empirical antibiotic therapy before receiving pathogen detection results as well as guidance on the classification as gonococcal or non-gonococcal urethritis based on clinical and microscopic findings. The recommendations for empirical therapy advise against the use of azithromycin as first-line treatment of urethritis to avoid further promoting resistance in NG and MG. DISCUSSION: A detailed presentation of the recommendations and underlying evidence can be found in the freely accessible guideline publication at the Association of the Scientific Medical Societies in Germany (AWMF): https://register.awmf.org/de/leitlinien/detail/013-099 .