Brief Answer:
I would not recommend further use, if Doxycyline is the right drug, one week would be sufficient

Detailed Answer:
Hi,

Generally Doxycycline for one week would be sufficient to treat the infection if Doxycycline would be the right antibiotic to use so to my opinion if you have used Doxycycline regularly for a week and you are not completely better there is no reason to go on with it.

Having the right diagnosis is crucial for effective treatment. Symptoms similar to urethritis can be caused by several conditions from urinary infection, urinary stones, prostatitis and local penile inflammation due to candida infection. It is not safe to assume the diagnosis but have the proper examination and tests to confirm it and get the proper treatment as treatment may vary depending on the cause.

If you have redness from the outside of the urethra at the penile head and itchiness very likely it is a local irritation due to candida (yeast infection)- treatment in this case is with local miconazole cream twice a day for 7-10 days

If you do not have local redness or itchiness then urinary infection or stones, urethritis or prostatitis are possible.

Doxycycline is a good antibiotic for urethritis if it is caused by chlamydia infection (a sexually transmitted infection) but not sufficient for urinary causes because it does not reach high concentration in urine. Very likely because you had partial improvement you are having a urinary cause and due to Doxycycline not being able to reach high concentration in urine you are not improved completely.

For urinary causes and prostatitis generally bactrim or ciprofloxacine are the best first choices.

To conclude:
- if you have redness or itchiness from outside the urethra you can try some miconazole cream twice a day for 7-10 days
- if you don't have redness or itchiness from outside very likely it is urinary infection or prostatitis if you are not sexually active or urethritis if you are sexually active
- the best treatment for urinary infection and prostatitis is bactrime or ciprofloxacine, make sure you do drink plenty of water (at least 2-3 liters a day)
- the treatment for urethritis (more likely if sexually active) is a combination of doxycycline and ceftriaxone
- finally, the best way to know the cause and best treatment is to have a visit and possible tests and examinations (urinalysis, urine culture, x-ray and ultrasound to determine presence of urinary stones or tests for sexually transmitted disease if sexually active, etc).

Please let me know of the above, it will help better determine the cause and further steps.

Waiting to hear from you.

Regards,
Dr. Antoneta Zotaj,
General and Family Physician

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Brief Answer:
Very likely this is due to a sexually transmitted infection, advices below

Detailed Answer:
Hi,

Thank you for the extra information provided.

By what you explain very likely the symptoms are due to a sexually transmitted disease (STD). The fact that your partner had urinary symptoms might be due to urethritis in her as well and ery likely to STD.
Normally tests are done to see if certain infection is identified it in your case the best way to treat especially because you have no insurance is to have empirical treatment with ceftriaxone 250 mg intramuscular single doze and azithromycine 1 g orally single dose. In the meantime your partner/s should get ceftriaxone 250 mg intramuscular single dose and doxycycline 100 mg twice a day for 10 days.
Abstein sexually for 2 weeks or use condoms to reduce chance of reinfection (abstaining is safer).

I hope I answered your query, let me know if I can assist you further.

Regards,

Antoneta Zotaj
General & Family Physician

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