What is the recommended antibiotic treatment for Ureaplasma (Ureaplasma urealyticum) infection in males?

Medical Advisory BoardAll articles are reviewed for accuracy by our Medical Advisory Board
Article Review Status
Submitted
Under Review
Approved

Last updated: March 31, 2025 • View editorial policy

From the Guidelines

For males with ureaplasma infection, the recommended first-line antibiotic treatment is doxycycline 100 mg taken orally twice daily for 7-14 days, as emphasized by the 2024 European Association of Urology guidelines on urological infections 1. The guidelines prioritize antimicrobial stewardship to combat the rising threat of antimicrobial resistance, providing recommendations for antibiotic selection, dosing, and duration based on the latest evidence. Key points to consider in the treatment of ureaplasma infection in males include:

  • The importance of a thorough medical history and physical examination to guide treatment decisions
  • The role of antimicrobial stewardship in combating antimicrobial resistance
  • The recommendation for doxycycline as the first-line treatment, with azithromycin as an alternative option
  • The need for partners to be treated simultaneously to prevent reinfection
  • The importance of abstaining from sexual activity during treatment and for 7 days after completing antibiotics. It is crucial to follow the guidelines and recommendations to ensure effective treatment and prevent the spread of infection, as supported by the latest evidence 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 treatment for Ureaplasma urealyticum in males is doxycycline 100 mg, by mouth, twice a day for 7 days 2.

  • Dosage: 100 mg, by mouth, twice a day
  • Duration: 7 days
  • Note: This treatment is for nongonococcal urethritis (NGU) caused by C. trachomatis or U. urealyticum.

From the Research

Ureaplasma Antibiotic Treatment in Males

  • The effectiveness of azithromycin and doxycycline in treating Ureaplasma urealyticum infections in men has been studied in several clinical trials 3, 4, 5, 6.
  • A study published in 1994 found that a single 1g dose of azithromycin was as effective as a 7-day regimen of doxycycline in treating Ureaplasma urealyticum infections in men 3.
  • Another study published in 2015 recommended azithromycin 1g single dose or 1.5g distributed in five days as a treatment option for non-gonococcal urethritis, which can be caused by Ureaplasma urealyticum 4.
  • A 1991 study compared the efficacy of azithromycin and doxycycline in treating non-gonococcal urethritis and found that azithromycin was effective in clearing Ureaplasma urealyticum infections 5.
  • A randomized double-blind study published in 1995 found that a single oral dose of azithromycin was as effective as a 7-day course of doxycycline in achieving clinical cure in men with non-gonococcal urethritis, regardless of the presence or absence of Ureaplasma infection 6.
  • Although the study published in 2001 was focused on female patients, it found that azithromycin was effective in treating Ureaplasma urealyticum infections, particularly when administered for 6 days 7.

Treatment Options

  • Azithromycin 1g single dose or 1.5g distributed in five days 4
  • Doxycycline 100mg twice daily for 7 days 3, 4
  • Azithromycin 500mg once daily for 3 days 5

Efficacy of Treatment

  • Azithromycin: 45-83% microbiological cure rate 3, 6
  • Doxycycline: 47-90% microbiological cure rate 3, 6

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.