POEM 16.03.17

Q. How do I treat resistant Mycoplasma Genitalium?

›Management of Mycoplasma genitalium infections – can we hit a moving target? BMC Infect Dis. 2015

Review and meta-analysis of 19 studies

  • Azithromycin standard single dose failure (40%)
  • No randomised controlled trial has compared azithromycin 1 g single dose with extended azithromycin 5 days, observational studies report microbiological cure rates of 81 and 88 % respectively.
  • In controlled clinical trials, the microbiological cure rate for doxycycline has ranged between 22 % and 45 %
  • Treatment failures have recently been reported in up to 30 % of patients treated with moxifloxacin
  • treatment with pristinamycin 1 g four times daily for 10 days is currently the only third or fourth line antimicrobial treatment that is available it is not licensed for use within Australia.

A. With some difficulty.

  • ›Do not screen asymptomatic
  • ›Extended course of Azithromycin 500mg plus 250mg 5/7
  • ›Doxycycline 100mg BD for 14 days
  • ›Moxifloxacin 400mg daily for 10 days

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