Ureaplasma Infection Management

Treatment Regimens

The Centers for Disease Control and Prevention recommends doxycycline 100 mg orally twice daily for 7 days as a first-line treatment option for Ureaplasma infections 2, 3
Azithromycin 1 g orally in a single dose is also recommended, particularly when compliance with a 7-day regimen may be an issue 4, 2
Erythromycin base 500 mg orally four times a day for 7 days and erythromycin ethylsuccinate 800 mg orally four times a day for 7 days are alternative treatment options 4, 1, 2
Ofloxacin 300 mg orally twice a day for 7 days and levofloxacin 500 mg orally once daily for 7 days are also alternative treatment options 4, 1, 2, 3

A test of cure is not recommended after completing treatment with doxycycline or azithromycin unless symptoms persist or reinfection is suspected 4, 1
Patients should only be retested if symptoms persist or reinfection is suspected 4, 1, 2
Consider a test of cure 3 weeks after completion of treatment with erythromycin due to its lower efficacy 4
Test of cure should be considered when therapeutic compliance is in question 1
If a test of cure is performed, it should be done no earlier than 3 weeks after completion of therapy 4, 1

If symptoms persist or recur after treatment, objective signs of infection should be present before initiating additional antimicrobial therapy 5, 3
For persistent or recurrent infection, consider re-treatment with the initial regimen if the patient was non-compliant or re-exposed to an untreated partner 5, 3
After first-line doxycycline failure, consider azithromycin 500 mg orally on day 1, followed by 250 mg daily for 4 days 3
After first-line azithromycin failure, consider moxifloxacin 400 mg orally once daily for 7-14 days 3

Sexual partners should be referred for evaluation and treatment 5, 2, 3
Treat partners with last sexual contact within 60 days of diagnosis 2, 3
Both patients and partners should abstain from sexual intercourse for 7 days after single-dose therapy or until completion of a 7-day regimen 4, 1, 2