Treatment of Ureaplasma STD in Women

First-Line Treatment Options

The Centers for Disease Control and Prevention recommends azithromycin 1 g orally in a single dose or doxycycline 100 mg orally twice daily for 7 days as the first-line treatment for Ureaplasma urealyticum infection in women 1, 2
Azithromycin is particularly useful for patients with questionable adherence to multi-day regimens, as single-dose therapy improves compliance 2
Doxycycline is equally effective as azithromycin but requires a longer treatment course and has a lower cost compared to azithromycin 1, 2

Erythromycin base 500 mg orally four times daily for 7 days or erythromycin ethylsuccinate 800 mg orally four times daily for 7 days can be considered as alternative treatment options 1, 2
Ofloxacin 300 mg orally twice daily for 7 days is also an alternative treatment option, although it is contraindicated in pregnancy 1, 3

Doxycycline and ofloxacin are contraindicated in pregnancy, and alternative options such as erythromycin base or amoxicillin should be considered 3, 4
Azithromycin 1 g orally in a single dose may be considered for pregnant women, although data on safety in pregnancy were limited in earlier guidelines 4
Patients with Ureaplasma infection who are also HIV-positive should receive the same treatment regimen as HIV-negative patients 2, 5

All sexual partners within the previous 60 days should be referred for evaluation and treatment, and partners should receive the same treatment as the index patient 1, 2, 5, 6
Both patients and partners should abstain from sexual intercourse until 7 days after completing a single-dose regimen or until completion of a 7-day regimen 2, 6

Patients treated with azithromycin or doxycycline generally do not require retesting unless symptoms persist or reinfection is suspected 4
If symptoms persist, patients should return for reevaluation, and consideration should be given to reevaluation for possible reexposure, assessment of partner treatment compliance, and evaluation for other potential causes of symptoms 5, 6