From the Guidelines
The treatment for Ureaplasma urealyticum infections should be doxycycline 100 mg twice daily for 7 days, as recommended by the European Association of Urology guidelines 1. This recommendation is based on the most recent and highest quality study available, which suggests doxycycline as the first-line therapy for Ureaplasma urealyticum infections 1. Some key points to consider when treating Ureaplasma urealyticum infections include:
- Azithromycin is an alternative option, given as a single 1-1.5 g dose 1
- The choice of antibiotic should be guided by local resistance patterns and patient factors, such as pregnancy or allergy history
- Sexual partners should be treated simultaneously to prevent reinfection
- Patients should abstain from sexual activity until both they and their partners complete treatment
- Ureaplasma urealyticum is resistant to antibiotics that target cell walls, making macrolides, tetracyclines, and fluoroquinolones effective alternatives 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 treatment for Ureaplasma urealyticum infections is doxycycline 100 mg, by mouth, twice a day for 7 days 2.
- The recommended dosage is for adults.
- The dosage for children is different and depends on their weight.
- It is essential to follow the recommended dosage and administration instructions to ensure effective treatment and minimize the risk of side effects.
From the Research
Treatment Options for Ureaplasma urealyticum Infections
- The treatment of Ureaplasma urealyticum infections is becoming increasingly challenging due to rising antibiotic resistance 3.
- Azithromycin has been studied as a potential treatment option, with mixed results. A single dose of azithromycin was found to be ineffective in reducing lower genital colonization of U. urealyticum in women at risk for preterm delivery 4.
- However, azithromycin has been shown to be effective in eradicating Ureaplasma spp. in preterm infants, with a single intravenous dose of 20 mg/kg being well-tolerated and effective in microbial clearance 5.
- Doxycycline has also been studied as a treatment option, with a 7-day course being found to be as effective as a single dose of azithromycin in treating chlamydial, mycoplasmic, and ureaplasmic cervicitis 6.
- Fluoroquinolones, such as levofloxacin and moxifloxacin, have been found to be effective against Ureaplasma spp., with lower resistance rates compared to other antibiotics 7, 3.
- The choice of treatment should be based on antimicrobial susceptibility patterns, with routine screening for genital mycoplasmas recommended to prevent complications in pregnant women, the fetus, and the neonate 7.
Antibiotic Resistance
- Ureaplasma spp. have been found to be resistant to several antibiotics, including erythromycin, tetracycline, and fluoroquinolones 7, 3.
- The resistance rates of Ureaplasma spp. to fluoroquinolones have been found to be increasing over time, with significant differences in resistance rates between different continents and countries 3.
- The use of newer fluoroquinolones, such as levofloxacin, is recommended as a first-line treatment option for genital mycoplasmosis, due to their lower resistance rates 3.