Treatment for Mycoplasma genitalium and Ureaplasma Infections

First-Line Treatment

• The Centers for Disease Control and Prevention recommends doxycycline 100 mg orally twice daily for 7 days as the first-line treatment for patients positive for both Mycoplasma genitalium and Ureaplasma 1, 2, 3, 4

Alternative Regimens

• The Centers for Disease Control and Prevention recommends erythromycin base 500 mg orally four times a day for 7 days or erythromycin ethylsuccinate 800 mg orally four times a day for 7 days as alternative regimens for patients who cannot tolerate doxycycline 1, 2

Management of Sex Partners

• The Centers for Disease Control and Prevention recommends that sex partners be referred for evaluation and treatment, with treatment of partners with last sexual contact within 30 days of symptom onset for symptomatic patients or within 60 days of diagnosis for asymptomatic patients 1, 2, 3
• Patients and partners should abstain from sexual intercourse until therapy is completed and symptoms have resolved 1, 3

Follow-Up Recommendations

• The Centers for Disease Control and Prevention recommends that patients return for evaluation if symptoms persist or recur after completing therapy, with re-treatment with the initial regimen if non-compliant with treatment or re-exposed to an untreated partner 1, 2, 3

Special Situations

• The Centers for Disease Control and Prevention recommends that HIV-infected patients be treated with the same regimens as HIV-negative patients 1, 3

Treatment of Ureaplasma Infection in Partners

First-Line Treatment Options

• Azithromycin 1 g orally in a single dose is an effective alternative first-line option, particularly when compliance with a 7-day regimen may be an issue, as recommended by the Centers for Disease Control and Prevention 5

Alternative Treatment Options

• Erythromycin base 500 mg orally four times a day for 7 days is an alternative treatment option for patients who cannot tolerate doxycycline or azithromycin, according to the MMWR Recommendations and Reports 5
• Levofloxacin 500 mg orally once daily for 7 days is an alternative treatment option for patients who cannot tolerate doxycycline or azithromycin 5
• Ofloxacin 300 mg orally twice a day for 7 days is an alternative treatment option for patients who cannot tolerate doxycycline or azithromycin 5

Post-Treatment Recommendations

• Both patients and partners should abstain from sexual intercourse for 7 days after single-dose therapy or until completion of a 7-day regimen, provided symptoms have resolved, as recommended by the MMWR Recommendations and Reports 5
• This abstinence period helps minimize the risk of reinfection, as stated in the MMWR Recommendations and Reports 5

Doxycycline and Alternative Regimens for Ureaplasma urealyticum Vaginitis (CDC‑Based Recommendations)

Treatment Duration

Alternative First‑Line Options for Intolerance

Management of Persistent Symptoms After Doxycycline

Applicability to Female Vaginitis

CDC Evidence on Clinical Impact and HIV Transmission Implications of Ureaplasma parvum

Clinical Manifestations in Sexually Active Adults

• Ureaplasma parvum can cause urethritis and cervicitis in sexually active adults, indicating that detection of the organism in symptomatic individuals warrants treatment rather than observation. 8

Effect of Treatment on HIV‑Infected Women

• In HIV‑infected women, treating U. parvum–associated cervicitis with the standard regimens reduces cervical HIV shedding and may lower the risk of HIV transmission to partners. 8