Treatment of Ureaplasma Infections in Men

First-Line Treatment Options

The European Urology guidelines recommend doxycycline 100 mg orally twice daily for 7 days as the most effective first-line treatment for Ureaplasma urealyticum infections 1
Doxycycline 100 mg orally twice daily for 7 days has been consistently recommended across multiple guidelines and has shown good efficacy in clinical trials 3

Azithromycin 1.0-1.5 g orally as a single dose is an alternative treatment option for Ureaplasma urealyticum infections, as recommended by the European Urology guidelines 1, 4
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, as recommended by the MMWR Recommendations and Reports 3, 5
Levofloxacin 500 mg orally once daily for 7 days is an alternative treatment option, as recommended by the European Urology guidelines 1
Ofloxacin 300 mg orally twice a day for 7 days is an alternative treatment option, as recommended by the MMWR Recommendations and Reports 3

The MMWR Recommendations and Reports recommend re-treatment with the initial regimen if the patient failed to comply with the initial regimen or was re-exposed to an untreated partner 3, 5
After first-line doxycycline failure, the European Urology guidelines recommend azithromycin 500 mg orally on day 1, followed by 250 mg daily for 4 days 1, 4
After first-line azithromycin failure, the European Urology guidelines recommend moxifloxacin 400 mg orally once daily for 7-14 days 1, 4

The MMWR Recommendations and Reports recommend that sexual partners be referred for evaluation and treatment 3
The European Urology guidelines and Praxis Medical Insights recommend treatment of partners with last sexual contact within 60 days of diagnosis 2
Patients and partners should abstain from sexual intercourse until therapy is completed and symptoms have resolved, as recommended by the MMWR Recommendations and Reports and Praxis Medical Insights 2, 3

The MMWR Recommendations and Reports recommend that patients return for evaluation if symptoms persist or recur after completing therapy 3, 5
Objective signs of urethritis should be present before initiating additional antimicrobial therapy, as recommended by the MMWR Recommendations and Reports 3

The MMWR Recommendations and Reports recommend that HIV-infected patients receive the same treatment regimens as HIV-negative patients 3
Persistent or recurrent urethritis may require urologic examination, though this often does not reveal a specific etiology, as recommended by the MMWR Recommendations and Reports 3