From the Guidelines
Ureaplasma urine infection in men should be treated with antibiotics, specifically doxycycline 100mg twice daily for 7-14 days as the first-line treatment, as recommended by the European Association of Urology guidelines 1. The treatment of Ureaplasma infections is crucial to prevent complications such as urethritis, epididymitis, and prostatitis.
- Symptoms of urethritis include mucopurulent or purulent discharge, dysuria, and urethral pruritus, although many urethral infections are asymptomatic 1.
- The role of Ureaplasma spp. in causing urethritis is debated, with recent data suggesting that U. urealyticum, but not U. parvum, is an aetiological agent in non-gonococcal urethritis (NGU) 1.
- Alternatives to doxycycline include azithromycin 1g as a single dose or 500mg on day 1 followed by 250mg daily for 4 more days, or fluoroquinolones like levofloxacin 500mg daily for 10-14 days if resistance is suspected.
- Sexual partners should be treated simultaneously to prevent reinfection, and abstinence or condom use is recommended during treatment.
- Ureaplasma is transmitted sexually and can persist in the urogenital tract, potentially leading to complications if untreated.
- Testing is typically done through PCR on urine or urethral swab samples, and after treatment, a follow-up test is advisable to confirm the infection has cleared, especially if symptoms persist. The European Association of Urology guidelines 1 provide the most recent and highest quality evidence for the treatment of Ureaplasma infections, and should be followed in clinical practice.
From the FDA Drug Label
Nongonococcal urethritis caused by Ureaplasma urealyticum. The answer is yes, doxycycline is indicated for the treatment of nongonococcal urethritis caused by Ureaplasma urealyticum, which can cause ureaplasma urine infection in men 2.
- Key points:
- Doxycycline is effective against Ureaplasma urealyticum.
- It is used to treat nongonococcal urethritis caused by this bacterium.
From the Research
Ureaplasma Urine Infection in Men
- Ureaplasma urealyticum has been associated with urethritis in men, but it is probably not causal unless a high load is present 3
- Routine testing and treatment of asymptomatic or symptomatic men for Ureaplasma urealyticum are not recommended due to the common asymptomatic carriage of these bacteria and the potential for antimicrobial resistance 3
- If testing of men with symptomatic urethritis is undertaken, traditional STI urethritis agents such as Neisseria gonorrhoeae, Chlamydia trachomatis, M. genitalium, and Trichomonas vaginalis should be excluded prior to U. urealyticum testing 3
Treatment of Ureaplasma Urine Infection in Men
- Azithromycin and doxycycline have been used to treat Ureaplasma urealyticum infections in men, with similar eradication and clinical cure rates 4
- The in vitro activity of various antibiotics, including tetracycline, doxycycline, erythromycin, and azithromycin, has been tested against Ureaplasma urealyticum, with moxifloxacin being the most active agent 5
- Resistance to macrolides, tetracyclines, and fluoroquinolones has been reported, highlighting the need for prompt diagnosis and appropriate antibiotic therapy 6
Diagnosis of Ureaplasma Urine Infection in Men
- Culture and polymerase chain reaction (PCR) are the mainstay of diagnosis, with commercial assays available for improved turnaround time 6
- Micro broth dilution is routinely used to test antimicrobial susceptibility of isolates, with testing against azithromycin, josamycin, ofloxacin, and doxycycline 6