This large, single center study analyzed the effects of their transition of the diagnosis and treatment of nongonococcal urethritis. While CDC guidelines recommend only testing patients who present with urethritis for CT/GC during the initial encounter, the San Francisco City Clinic (SFCC) implemented additional initial testing for mycoplasma genitalium. Furthermore, all patients were empirically treated with doxycycline only, even though azithromycin is also an approved empiric treatment. These changes resulted in a lower rate of return visits for persistent urethritis (3% vs 8%), and M. genitalium was detected at 18 percent of visits. Thus, it is now recommended that all symptomatic patients with urethritis, cervicitis, and pelvic inflammatory disease (PID) be tested for MG during initial encounter, and doxycycline is the first-line empiric treatment for these conditions.
