From the Guidelines
Ureaplasma urealyticum infections should be treated with doxycycline 100 mg twice daily for 7 days, as recommended by the European Association of Urology guidelines 1. The treatment of Ureaplasma urealyticum infections is crucial to prevent long-term complications and improve patient outcomes. Key points to consider when treating Ureaplasma urealyticum infections include:
- The use of doxycycline as the first-line treatment, due to its effectiveness and safety profile 1.
- Alternative treatment options, such as azithromycin 1.0-1.5 g orally as a single dose, can be considered in cases where doxycycline is contraindicated or not tolerated 1.
- The importance of treating sexual partners simultaneously to prevent reinfection and ensuring patients abstain from sexual activity until treatment is complete and symptoms resolve.
- The need for follow-up testing to confirm treatment success, especially in cases of persistent symptoms.
- The mechanism of action of the recommended antibiotics, which inhibit bacterial protein synthesis or DNA replication, effectively eliminating the infection 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. Ureaplasma urealyticum Azithromycin has been shown to be active against most isolates of the following bacteria, both in vitro and in clinical infections ... “Other” bacteria ... Ureaplasma urealyticum
The treatment for Ureaplasma (Ureaplasma urealyticum) infection is:
- Doxycycline: 100 mg, by mouth, twice a day for 7 days 2
- Azithromycin may also be effective, but the exact dosage is not specified in the provided drug labels 3
From the Research
Treatment Options for Ureaplasma Infection
- Azithromycin has been shown to be effective in treating Ureaplasma urealyticum infections, with a single 1 g dose being comparable to a 7-day regimen of doxycycline 4, 5.
- Doxycycline is also a commonly used treatment for Ureaplasma infections, with studies showing it to be effective against Ureaplasma urealyticum 4, 6, 7.
- Josamycin and clarithromycin are also active against Ureaplasma urealyticum, and may be considered as alternative treatments 6, 7.
- Fluoroquinolones, such as ofloxacin and ciprofloxacin, have been shown to have low efficacy against Ureaplasma urealyticum 6, 7.
- Moxifloxacin has been used as a treatment for persistent Ureaplasma infections, but failure rates have been reported to be around 30-36% 8.
Antimicrobial Susceptibility
- Ureaplasma urealyticum isolates have been shown to be susceptible to doxycycline (91%), josamycin (86%), and ofloxacin (77%), with lower susceptibility to azithromycin (71%) 6.
- Mycoplasma hominis isolates have been shown to be uniformly susceptible to doxycycline, josamycin, and ofloxacin 6, 7.
- Cross-resistance has been reported between erythromycin and macrolides (except josamycin) (40-80%), and between erythromycin and ciprofloxacin (79%) 7.
Treatment Outcomes
- Persistent detection of Ureaplasma urealyticum after treatment with azithromycin, doxycycline, and moxifloxacin has been reported, but was not associated with persistent urethritis 8.
- Species-specific treatment outcomes have been reported, with Ureaplasma urealyticum biovar 2 (UU-2) being more commonly associated with non-gonococcal urethritis than Ureaplasma parvum (UP) 8.