From the Guidelines
Ureaplasma, also known as Uro mycoplasma, is a type of bacteria that can cause vaginal infections, and its treatment typically involves antibiotics, with doxycycline being the first-line treatment, as recommended by the European Association of Urology guidelines 1. When present in high numbers or when the immune system is compromised, Ureaplasma can cause symptoms like vaginal discharge, pain during urination, pelvic pain, or discomfort during intercourse.
- The first-line treatment for Ureaplasma infection is doxycycline, with a dosage of 100 mg twice daily for 7 days 1.
- Alternative treatments include azithromycin, with a dosage of 1.0-1.5 g orally as a single dose 1, or moxifloxacin, with a dosage of 400 mg daily for 7-14 days, which is recommended for cases of macrolide resistance 1. It's essential to complete the full course of antibiotics even if symptoms improve before finishing treatment, as Ureaplasma infections can sometimes be associated with complications like pelvic inflammatory disease, infertility, or pregnancy complications if left untreated 1.
- Sexual partners should also be treated simultaneously to prevent reinfection. The European Association of Urology guidelines provide a comprehensive overview of the treatment options for Ureaplasma infections, and it's crucial to follow these guidelines to ensure effective treatment and prevent potential complications 1.
From the Research
Definition and Transmission of Mycoplasma Genitalium
- Mycoplasma genitalium is a sexually transmitted infection that can cause urethritis, cervicitis, and pelvic inflammatory disease (PID) 2.
- It is transmitted through direct mucosal contact and can be asymptomatic in many cases 2.
Symptoms of Mycoplasma Genitalium Infection
- In men, symptoms include urethritis, dysuria, and discharge 2.
- In women, symptoms include vaginal discharge, dysuria, and symptoms of PID such as abdominal pain and dyspareunia 2.
Diagnosis and Treatment of Mycoplasma Genitalium Infection
- Diagnosis is achievable only through nucleic acid amplification testing and must include investigation for macrolide resistance mutations 2.
- The current guidelines recommend azithromycin as the first-line treatment, with moxifloxacin as a second-line treatment 3, 2, 4.
- Moxifloxacin has been shown to be effective in treating Mycoplasma genitalium infection, with a cure rate of 89-100% 3, 4, 5.
- However, resistance to moxifloxacin is increasing, and its use should be guided by resistance testing 3, 2.
Treatment Options for Mycoplasma Genitalium Infection
- Azithromycin 500 mg on day one, then 250 mg on days 2-5 (oral) is recommended as first-line treatment 2.
- Moxifloxacin 400 mg od for 7 days (oral) is recommended as second-line treatment 2.
- Doxycycline or minocycline 100 mg bid for 14 days (oral) may be used as third-line treatment 2.
- Pristinamycin 1 g qid for 10 days (oral) has a cure rate of around 75% 2.