What antibiotic gets rid of urethritis? A guide to treatment and causes

October 12, 2025 •

3 min read

According to the Centers for Disease Control and Prevention (CDC), urethritis is one of the most common sexually transmitted infections (STIs) in men. Understanding what antibiotic gets rid of urethritis is crucial, as the correct medication depends on the specific bacteria causing the infection.

Quick Summary

This article explores the different antibiotic treatments for urethritis, distinguishing between gonococcal and nongonococcal causes. It details the specific medications used for Neisseria gonorrhoeae, Chlamydia trachomatis, and Mycoplasma genitalium, emphasizing the importance of following medical guidelines to combat growing antibiotic resistance.

Key Points

Specific Diagnosis is Critical: The correct antibiotic for urethritis depends entirely on the specific infectious organism identified, such as gonorrhea, chlamydia, or mycoplasma.
Empiric Therapy for Unconfirmed Cases: For an initial diagnosis without a confirmed cause, empiric treatment often involves a combination of ceftriaxone and doxycycline to cover common sexually transmitted pathogens.
Rising Antibiotic Resistance: Resistance is a major concern, particularly for Mycoplasma genitalium and Neisseria gonorrhoeae, necessitating specific treatment approaches.
Partner Treatment is Essential: To prevent reinfection, all sexual partners must be tested and treated simultaneously.
Completing the Full Course is Non-Negotiable: Even if symptoms improve, patients must finish the entire course of antibiotics as prescribed to fully eradicate the infection and minimize resistance.
Follow-up is Necessary for Persistent Symptoms: If symptoms persist after treatment, follow-up testing is needed to check for re-infection, noncompliance, or antibiotic resistance.

Types of Urethritis and Their Causes

Urethritis is primarily classified into two types, determined through physical examination and testing:

Gonococcal Urethritis (GU)

Caused by Neisseria gonorrhoeae, this type is frequently associated with a thick, pus-like discharge.

Nongonococcal Urethritis (NGU)

NGU results from infections other than N. gonorrhoeae. Common causes include Chlamydia trachomatis, Mycoplasma genitalium, and Trichomonas vaginalis.

What Antibiotic Gets Rid of Urethritis? Treatment Guidelines

Treatment protocols are tailored to the identified pathogen. Empiric treatment, covering the most likely causes, may be administered before test results are finalized.

Empiric Treatment

Initial treatment for suspected urethritis without a confirmed cause aims to cover gonorrhea and chlamydia. Recommended regimens typically include an injection of ceftriaxone combined with oral doxycycline.

Treatment for Neisseria gonorrhoeae

Uncomplicated gonorrhea is primarily treated with an injection of ceftriaxone. This reflects updated CDC guidelines due to increasing resistance to older antibiotics. Alternative regimens are available if ceftriaxone is not an option.

Treatment for Chlamydia trachomatis

The preferred treatment is oral doxycycline. This is highly effective and addresses potential co-infections. An oral dose of azithromycin is an alternative, but may have lower success rates.

Treatment for Mycoplasma genitalium

Treating M. genitalium is challenging due to widespread macrolide resistance. A sequential therapy is recommended, starting with doxycycline, followed by either azithromycin (if sensitive) or moxifloxacin (if resistant). Resistance testing is advised to guide the choice of the second antibiotic.

Treatment for Trichomonas vaginalis

This cause of NGU is treated with antiprotozoal medications. Oral metronidazole or tinidazole are standard treatments.

Partner Treatment and Adherence

To prevent reinfection, all sexual partners must be treated. Completing the entire course of antibiotics as prescribed is crucial to fully clear the infection, prevent complications, and minimize the development of antibiotic resistance.

Risks of Untreated Urethritis

Failure to complete treatment can lead to persistent symptoms, reinfection, antibiotic resistance, and complications like epididymitis or pelvic inflammatory disease (PID).

Comparison of Common Antibiotic Regimens for Urethritis


Type of Urethritis	Primary Cause	Standard Treatment	Considerations
Gonococcal Urethritis (GU)	Neisseria gonorrhoeae	Ceftriaxone (IM) + Doxycycline (oral)	Addresses possible chlamydia co-infection; reflects current guidelines.
Nongonococcal Urethritis (NGU)	Chlamydia trachomatis	Doxycycline (oral)	Considered a preferred treatment option.
Nongonococcal Urethritis (NGU)	Mycoplasma genitalium	Sequential Therapy (Doxycycline, then Moxifloxacin or Azithromycin)	Complex protocol due to high resistance rates; requires careful follow-up and possibly resistance testing.
Nongonococcal Urethritis (NGU)	Trichomonas vaginalis	Metronidazole (oral) or Tinidazole (oral)	Also effective against some anaerobic bacteria; partners must also be treated.

Conclusion: Personalized Treatment and Adherence Are Key

The appropriate antibiotic for urethritis is dependent on the specific cause. A healthcare provider's diagnosis is essential for effective treatment. Completing the full course of prescribed antibiotics, ensuring all sexual partners are treated, and abstaining from sexual activity during treatment are critical steps for successful recovery and preventing the spread of infection and resistance. For further guidance, refer to official sources like the Centers for Disease Control and Prevention.

Frequently Asked Questions

There is no single 'best' antibiotic, as treatment depends on the cause. For gonorrhea, ceftriaxone is used. For chlamydia, doxycycline is the preferred treatment. For Mycoplasma genitalium, a two-stage regimen with doxycycline and moxifloxacin is often required due to resistance.

Standard treatment for NGU, where gonorrhea is ruled out, typically involves doxycycline. An oral dose of azithromycin is an alternative, but may be less effective against some pathogens.

A single dose of azithromycin is often not recommended because of high rates of macrolide resistance in M. genitalium, leading to a high likelihood of treatment failure.

Yes. All recent sexual partners should be evaluated and treated to prevent reinfection and further spread of the infection. In many areas, expedited partner therapy (EPT) is available.

If left untreated, urethritis can lead to complications such as epididymitis (inflammation of the epididymis) in men and pelvic inflammatory disease (PID) in women.

If symptoms persist or recur, you should be reevaluated by a healthcare provider. Causes could include re-infection, noncompliance with medication, or a resistant organism like Mycoplasma genitalium.

Yes, you should abstain from sexual activity for a period after starting treatment and until all sexual partners have also been adequately treated and symptoms have fully resolved.