Treatment for Mycoplasma Genitalium

Diagnostic Considerations

• The Centers for Disease Control and Prevention recommends testing for M. genitalium in patients with urethritis, cervicitis, or related genital tract infections 2
• Testing for both gonorrhea and chlamydia should also be performed in patients with suspected M. genitalium infection, as co-infections are common 2, 3

First-Line Treatment Options

• The Centers for Disease Control and Prevention recommends Azithromycin 1 g orally in a single dose as the preferred first-line treatment for Mycoplasma genitalium infections, as it has better efficacy against this pathogen compared to doxycycline 1, 2, 3
• Infections with M. genitalium respond better to azithromycin than to doxycycline, which has only 30-40% cure rate 3

Alternative Treatment Options

• Doxycycline 100 mg orally twice daily for 7 days can be used as an alternative regimen, though it is less effective 3, 4
• Other alternative regimens include erythromycin base 500 mg orally four times daily for 7 days, erythromycin ethylsuccinate 800 mg orally four times daily for 7 days, levofloxacin 500 mg orally once daily for 7 days, and ofloxacin 300 mg orally twice daily for 7 days 3

Follow-Up Recommendations

• Patients should be instructed to return for evaluation if symptoms persist or recur after completion of therapy, and partners should be evaluated and treated to prevent reinfection 3, 4
• Patients should abstain from sexual intercourse for 7 days after single-dose therapy or until completion of a 7-day regimen 3
• Test of cure is not routinely recommended if symptoms resolve 3