Management of Detected Ureaplasma parvum and Ureaplasma urealyticum

Diagnosis and Treatment

The American College of Physicians recommends that patients with documented symptoms of urethritis, such as mucopurulent discharge, dysuria, or urethral pruritus, should be treated, and treatment should not be based on testing alone 1, 2, 3
The European Urology Association suggests asking patients specifically about symptoms such as mucopurulent or purulent urethral discharge, dysuria, or urethral pruritus 4, 5, 6
The Centers for Disease Control and Prevention recommends documenting objective evidence of urethritis with a Gram stain showing >5 WBCs per oil immersion field, a positive leukocyte esterase test on first-void urine, or microscopic examination showing >10 WBCs per high-power field on first-void urine 5, 6

The American College of Physicians recommends doxycycline 100 mg orally twice daily for 7 days as first-line treatment, which achieves 91% susceptibility rates 1, 2, 3
The European Urology Association suggests azithromycin 1 g orally as a single dose as an alternative regimen, which achieves 71% susceptibility rates 1, 2, 3
The Centers for Disease Control and Prevention recommends erythromycin base 500 mg orally four times daily for 7 days as an alternative regimen 1, 2, 3

The American College of Physicians recommends that all sexual partners with contact within 60 days of diagnosis must be evaluated and treated 1, 3
The Centers for Disease Control and Prevention suggests that both patient and partners must abstain from sexual intercourse for 7 days after single-dose therapy or until completion of 7-day regimen 1, 3

The American College of Physicians recommends that test-of-cure is not routinely recommended after treatment unless symptoms persist or reinfection is suspected 2, 3
The European Urology Association suggests that patients should return for evaluation only if symptoms persist or recur after completing therapy 2, 3