Treatment of Mycoplasma Infections in Men

Diagnostic Approach

The Centers for Disease Control and Prevention recommends that all patients with suspected urethritis should be tested for gonorrhea and chlamydia, with specific testing for Mycoplasma genitalium when available 1, 3
Objective evidence of urethral inflammation should be obtained when possible, such as a leukocyte esterase test or microscopic examination showing ≥10 WBC per high-power field, as recommended by the Centers for Disease Control and Prevention 1

The Centers for Disease Control and Prevention recommends azithromycin 1g orally in a single dose as the first-line treatment for Mycoplasma genitalium infections 1, 2, 3

The Centers for Disease Control and Prevention suggests doxycycline 100mg orally twice daily for 7 days as an alternative treatment option, but with lower efficacy 1, 3

The Centers for Disease Control and Prevention recommends that patients should be instructed to return for evaluation if symptoms persist or recur after treatment, abstain from sexual intercourse for 7 days after single-dose therapy or until completion of a 7-day regimen, and that partners should be evaluated and treated to prevent reinfection 1, 3
The Centers for Disease Control and Prevention also recommends testing for other STIs, including syphilis and HIV, as part of the follow-up care 1, 3