From the Research
Mycoplasma genitalium is a serious sexually transmitted infection that can cause significant health problems if left untreated, and testing, treatment, and partner treatment are crucial to prevent long-term complications. Mycoplasma genitalium can cause urethritis in men, with symptoms like burning during urination and discharge, and in women, it can cause cervicitis, pelvic inflammatory disease, and is associated with bacterial vaginosis (BV), but can also lead to more serious complications like infertility and increased risk of preterm birth 1. Testing for M. genitalium is available through nucleic acid amplification tests (NAATs) and is typically recommended for people with persistent urethritis, cervicitis, or pelvic inflammatory disease, as well as for sexual contacts of patients with MG 1. Partner treatment is strongly recommended to prevent reinfection, even if partners have no symptoms. The recommended treatment is usually a two-stage approach with doxycycline (100mg twice daily for 7 days) followed by azithromycin or moxifloxacin, with moxifloxacin recommended if resistance testing is unavailable or testing demonstrates macrolide resistance 1. Some key points to consider include:
- Testing should be focused to avoid inappropriate antibiotic use 1
- Testing is not recommended in asymptomatic patients, including pregnant patients, who do not have a history of MG exposure 1
- Resistance-guided therapy is recommended, but there are currently no FDA approved tests for MG macrolide resistance, and tests are not widely available in the United States 1
- A test of cure is recommended 3-4 weeks after completing treatment due to high rates of treatment failure and antibiotic resistance 2. Beyond BV, M. genitalium can cause more serious reproductive tract infections and complications, making proper diagnosis and treatment essential 1.