Treatment for Mycoplasma genitalium and Ureaplasma spp. Co-infection

Primary Treatment: Mycoplasma genitalium

The American College of Physicians recommends treating Mycoplasma genitalium infection with azithromycin 500 mg orally on day 1, then 250 mg orally daily on days 2-5, as this regimen achieves 85-95% cure rates in macrolide-susceptible infections 1
The Centers for Disease Control and Prevention suggests that M. genitalium is an established sexually transmitted infection requiring treatment when detected by nucleic acid amplification testing, as it causes urethritis, cervicitis, and pelvic inflammatory disease with significant morbidity if untreated 1

The American College of Physicians recommends that all sexual partners within the preceding 60 days must be evaluated and treated simultaneously, regardless of symptoms, to prevent reinfection and ongoing transmission 1
Partners should receive the same M. genitalium treatment regimen, and both patient and partners must abstain from sexual intercourse until 7 days after completing therapy, as reinfection rates are high without proper partner management 1

The Centers for Disease Control and Prevention recommends instructing the patient to return if symptoms persist or recur after completing therapy, and consider repeat testing at 3-6 months due to high reinfection rates, particularly if partner treatment compliance is uncertain 1

The Centers for Disease Control and Prevention suggests ensuring testing for N. gonorrhoeae and C. trachomatis has been completed, as co-infections are common, and perform syphilis serology and HIV testing with counseling, as recommended for all patients with sexually transmitted infections 2, 3, 4, 5