Evolving Strategies for Management of the Nongonococcal Urethritis Syndrome

Nongonococcal urethritis (NGU) is the most common sexually transmitted disease (STD) syndrome that occurs in men and accounts for an estimated 4 million to 6 million physician visits annually.1As with other sexually transmitted infections, the clinical management of patients with NGU ideally should include accurate identification of the most likely causative agent; prompt administration of effective antimicrobial therapy to alleviate symptoms, eradicate the causative organism, and prevent secondary complications; and initiation of appropriate counseling and intervention for notification and treatment of sexual partners. Unfortunately, in caring for patients with NGU, these components of clinical management are not straightforward. Clinicians have difficulty identifying patients with NGU because many are asymptomatic and not all of the organisms that cause NGU are known. In addition, current therapies are not ideal, and appropriate counseling and partner notification are made difficult by uncertainties in each of these areas. Fortunately, the investigation by Stamm