From the Guidelines
Ureaplasma infections should be treated with doxycycline as the first-line treatment at 100 mg twice daily for 7 days, as recommended by the European Association of Urology guidelines 1. The treatment of Ureaplasma infections is crucial to prevent complications such as urethritis, cervicitis, and pelvic inflammatory disease.
- The first-line treatment for Ureaplasma infections is doxycycline, which is administered at a dose of 100 mg twice daily for 7 days 1.
- Alternative treatments include azithromycin, which can be given as a single dose of 1 gram or 500 mg on day 1 followed by 250 mg daily for 4 more days 1.
- It is essential to treat sexual partners to prevent reinfection and to advise patients to abstain from sexual activity until both partners complete treatment 1.
- For persistent infections, extended therapy may be necessary, possibly with a different antibiotic class.
- Ureaplasma is a bacteria that commonly colonizes the genitourinary tract, and these antibiotics work by inhibiting bacterial protein synthesis or DNA replication, effectively eliminating the infection.
- Follow-up testing may be recommended 3-4 weeks after treatment to confirm clearance, especially in cases of recurrent symptoms or treatment failure. The European Association of Urology guidelines emphasize the importance of differentiating between gonococcal urethritis and non-gonococcal urethritis, and Ureaplasma urealyticum is considered an aetiological agent in non-gonococcal urethritis 1.
From the FDA Drug Label
Nongonococcal urethritis (NGU) caused by C. trachomatis or U. urealyticum: 100 mg, by mouth, twice a day for 7 days. The recommended dose of doxycycline for the treatment of Ureaplasma infection is 100 mg, by mouth, twice a day for 7 days 2.
- The treatment is for Nongonococcal urethritis (NGU) caused by C. trachomatis or U. urealyticum.
- The dosage is the same for adults.
- Doxycycline is effective against Ureaplasma urealyticum.
From the Research
Ureaplasma Treatment Options
- Azithromycin and doxycycline are commonly used antibiotics for treating Ureaplasma urealyticum infections 3, 4, 5, 6
- The efficacy of azithromycin in treating Ureaplasma urealyticum has been shown to be comparable to doxycycline in several studies 4, 5, 6
- A systematic review and meta-analysis found that azithromycin has a comparable therapeutic effect on Ureaplasma urealyticum compared to controls 6
Antibiotic Susceptibility
- Ureaplasma urealyticum has been shown to be susceptible to various antibiotics, including tetracycline, doxycycline, erythromycin, roxithromycin, clarithromycin, azithromycin, levofloxacin, and moxifloxacin 7
- Moxifloxacin was found to be the most active agent in vitro against U. urealyticum, followed closely by levofloxacin 7
- Clarithromycin was found to be the most active macrolide against U. urealyticum 7
Treatment Duration and Dose
- The duration and dose of azithromycin may not affect its efficacy in treating Ureaplasma urealyticum 6
- A study found that a single dose of azithromycin was as effective as a 7-day course of doxycycline in achieving clinical cure 5
- Another study found that azithromycin at a dose of 1 x 500 mg/6 days was more effective than a single dose of 1 g in patients with disease symptoms lasting for 3 weeks or longer 3