title: Mycoplasma genitalium: should we treat and how?
abstract: Mycoplasma genitalium is associated with acute and chronic urethritis in men. Existing data on infection in women are limited and inconsistent but suggest that M. genitalium is associated with urethritis, cervicitis, pelvic inflammatory disease, and possibly female infertility. Data are inconclusive regarding the role of M. genitalium in adverse pregnancy outcomes and ectopic pregnancy. Available data suggest that azithromycin is superior to doxycycline in treating M. genitalium infection. However, azithromycin-resistant infections have been reported in 3 continents, and the proportion of azithromycin-resistant M. genitalium infection is unknown. Moxifloxacin is the only drug that currently seems to uniformly eradicate M. genitalium. Detection of M. genitalium is hampered by the absence of a commercially available diagnostic test. Persons with persistent pelvic inflammatory disease or clinically significant persistent urethritis or cervicitis should be tested for M. genitalium, if possible. Infected persons who have not previously received azithromycin should receive that drug. Persons in whom azithromycin therapy fails should be treated with moxifloxicin.
authors.affiliation: Departments of Epidemiology, University of Washington, Center for AIDS and STD, 325 9th Ave, Box 359931, Seattle, WA 98104, USA. lmanhart@u.washington.edu
authors.forename: Lisa E
authors.initials: LE
authors.lastname: Manhart
authors.forename: Jennifer M
authors.initials: JM
authors.lastname: Broad
authors.forename: Matthew R
authors.initials: MR
authors.lastname: Golden
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001372:Aza Compounds / Q000627:therapeutic use; D017963:Azithromycin / Q000627:therapeutic use; D004318:Doxycycline / Q000627:therapeutic use; D024881:Drug Resistance, Bacterial; D005260:Female; D024841:Fluoroquinolones; D006801:Humans; D007247:Infertility, Female / Q000209:etiology; D008297:Male; D000077266:Moxifloxacin; D009175:Mycoplasma Infections / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy*; D045704:Mycoplasma genitalium / Q000302:isolation & purification*; D000292:Pelvic Inflammatory Disease / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology; D011247:Pregnancy; D011271:Pregnancy, Ectopic / Q000209:etiology; D011804:Quinolines / Q000627:therapeutic use; D016896:Treatment Outcome; D014526:Urethritis / Q000175:diagnosis* / Q000188:drug therapy* / Q000382:microbiology; D002575:Uterine Cervicitis / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology
chemical_list: D000900:Anti-Bacterial Agents; D001372:Aza Compounds; D024841:Fluoroquinolones; D011804:Quinolines; D017963:Azithromycin; D004318:Doxycycline; D000077266:Moxifloxacin
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