Abstract

The conclusions, where pertinent, of the 10 papers on the treatment of non-specific urethritis which have appeared in the British Journal of Venereal Diseases between 1971 and now are reviewed. Recent studies purport to argue, but in fact assume, that tetracyclilne treatment for non-specific urethritis is both effective and desirable; current practice agrees with this assumption. To prove effectiveness, studies over much longer follow-up periods would be necessary. These studies should compare results not only of different methods and doses of tetracycline, of different regimens, and of different types of the drug; they should also compare results over a prolonged period with placebos and with other drugs, for instance those outside the antibiotic range and with no suspected side effects. Only then would it be reasonable to hold a firm view on the desirability or the effectiveness of the treatment. With patience and properly conducted experiments results may emerge to justify some view. At the moment the data are ill-assembled although voluminous and fail to support conclusions that have any clarity or force; moreover they are so haphazard that they cannot be compared with one another. Some venereologists are sceptical about treatment, some advocate the administration of one single dose, others say the four- or five-day regimen is preferable, and so on up to those who maintain that the 21-day regimen is the best. The coexistence of such mutually incompatible, firmly-held views may well suggest that the whole system of investigation put together to validate such views is quite inappropriate. That would be a radical thesis, and perhaps none the worse for that. What is not a radical thesis, however, is that at present the whole system of data and argument is in disarray.