Moxifloxacin for Mycoplasma genitalium

Treatment Algorithm

The European Urology guideline recommends Moxifloxacin 400 mg once daily for 7 days (14 days for complicated infections) as the second-line treatment for Mycoplasma genitalium infection, particularly when macrolide resistance is present or after azithromycin failure 1
Azithromycin remains first-line for uncomplicated M. genitalium infection without documented macrolide resistance: 500 mg on day 1, then 250 mg daily on days 2-5 1
Moxifloxacin 400 mg once daily for 7 days is recommended for uncomplicated macrolide-resistant M. genitalium infection 1
Moxifloxacin 400 mg once daily for 14 days is recommended for complicated infections (pelvic inflammatory disease, epididymitis) 1

Moxifloxacin is indicated for documented macrolide resistance mutations on resistance testing 1
Moxifloxacin is indicated for treatment failure after azithromycin therapy 1
Moxifloxacin is indicated for complicated infections requiring longer therapy duration 1