Management of Ureaplasma Species Infection

Diagnosis and Treatment

The European Association of Urology recommends treating Ureaplasma species infection only in patients with documented urethritis symptoms or objective signs of inflammation 1, 2
The European Association of Urology guidelines emphasize that U. urealyticum, but not U. parvum, is an aetiological agent in non-gonococcal urethritis (NGU) 1, 3

The European Association of Urology recommends doxycycline 100 mg orally twice daily for 7 days as the first-line treatment for Ureaplasma urealyticum infection 4, 5, 6
Azithromycin 1.0-1.5 g orally as a single dose is an alternative treatment option when doxycycline is contraindicated or not tolerated 4, 5
Erythromycin base 500 mg orally four times daily for 7 days is another alternative treatment option, although resistance to macrolides is increasingly common 6, 5

The Centers for Disease Control and Prevention recommends assessing treatment compliance and partner re-exposure in patients with persistent or recurrent symptoms after initial doxycycline therapy 6, 7
Azithromycin 500 mg orally on day 1, followed by 250 mg daily for 4 days, is recommended for patients with persistent or recurrent symptoms who have not responded to initial doxycycline therapy 4, 5

The European Association of Urology recommends that all sexual partners require evaluation and treatment to prevent reinfection 4, 5, 2
Partners with last sexual contact within 30 days of symptom onset should be treated for symptomatic patients, and within 60 days of diagnosis for asymptomatic patients 6, 8, 5

The Centers for Disease Control and Prevention recommends that patients return for evaluation only if symptoms persist or recur after completing therapy 6, 5
Test-of-cure is not routinely recommended for asymptomatic patients 5

The Centers for Disease Control and Prevention recommends that HIV-infected patients receive the same treatment regimens as HIV-negative patients, with no modification needed 6, 8, 5