Practical recommendations for the drug treatment of bacterial infections of the male genital tract including urethritis, epididymitis and prostatitis.

Bacterial infections of the male genital tract in young men (<35 years old) are primarily caused by sexually transmissible bacteria like Chlamydia trachomatis, Neisseria gonorrhoeae but also Mycoplasma or Haemophilus spp. In men aged over 35 years, Enterobacteriaceae are more frequently involved in urethritis, epididymitis and prostatitis. The traditional treatments suggested like tetracyclines or erythromycin are less effective since bacterial resistance is increasingly frequent, particularly in N. gonorrhoeae. Moreover, patient compliance with these drug treatments are frequently not well observed. New therapies including short term therapy with fluoroquinolones or azalides (e.g. azithromycin) are very effective and easy to use and thus eliminate any problem of compliance. However, we have to be vigilant for the emergence of resistant strains to these agents.