From the Guidelines
Azithromycin is the recommended treatment for Mycoplasma genitalium infection in pregnant patients.
Treatment Options
- Azithromycin is highly effective against M. genitalium infections 1
- Single-dose regimens of azithromycin can improve compliance and treatment outcomes
- Doxycycline is not recommended for pregnant patients due to potential fetal harm, making azithromycin a safer alternative ### Administration
- Medications should be dispensed on-site in the clinic to maximize compliance
- The first dose of azithromycin should be directly observed to ensure treatment initiation 1
From the Research
Treatment of Mycoplasma genitalium infection in pregnant patients
- The recommended first-line treatment for Mycoplasma genitalium infection in pregnant patients is azithromycin 2, 3.
- The dosing schedule of azithromycin varies between guidelines, with some recommending a single dose and others recommending a 5-day regimen 2, 4.
- Azithromycin is considered safe for use in pregnancy, but there is limited data on the safety of pristinamycin, which may be used as an alternative treatment for macrolide-resistant infections 2.
- Moxifloxacin is not recommended for use in pregnant patients due to potential safety concerns 2.
Rationale for treatment
- Mycoplasma genitalium infection has been linked to adverse pregnancy outcomes, including preterm birth and low birth weight 5.
- Treatment of genital mycoplasma in colonized pregnant women in late pregnancy has been associated with a lower rate of premature labor and neonatal complications 6.
- However, there is currently no general rule to screen and treat for mycoplasmata in pregnancy, and further studies are needed to determine the optimal treatment strategy 3, 5.
Azithromycin regimens
- A meta-analysis of azithromycin treatment studies found that the 5-day regimen may be more effective and less likely to cause resistance than the single-dose regimen 4.
- However, the optimal azithromycin regimen for treating Mycoplasma genitalium infection in pregnant patients is not yet established, and further research is needed to determine the best treatment approach 2, 4.