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Time to eradication of Mycoplasma genitalium after antibiotic treatment in men and women.
Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Östergötlands Läns Landsting, Local Health Care Services in West Östergötland, Research & Development Unit in Local Health Care. Linköping University, Faculty of Medicine and Health Sciences.ORCID iD: 0000-0001-8336-9767
Vastervik Hosp, Vastervik, Sweden.
Statens Serum Institut Köpenhamn.
2015 (English)In: Journal of Antimicrobial Chemotherapy, ISSN 0305-7453, E-ISSN 1460-2091, Vol. 70, no 11, 3134-3140 p.Article in journal (Refereed) Published
Abstract [en]

OBJECTIVES:

The objectives of this study were to evaluate the time to a Mycoplasma genitalium-negative test after start of treatment and to monitor if and when antibiotic resistance developed.

METHODS:

Sexually transmitted disease (STD) clinic attendees with suspected or verified M. genitalium infection were treated with azithromycin (5 days, 1.5 g; n = 85) or moxifloxacin (n = 5). Subjects with symptomatic urethritis or cervicitis of unknown aetiology were randomized to either doxycycline (n = 49) or 1 g of azithromycin as a single dose (n = 51). Women collected vaginal specimens and men collected first-catch urine 12 times during 4 weeks. Specimens were tested for M. genitalium with a quantitative MgPa PCR and for macrolide resistance-mediating mutations with a PCR targeting 23S rRNA.

CLINICAL TRIALS REGISTRATION:

NCT01661985.

RESULTS:

Ninety M. genitalium cases were enrolled. Of 56 patients with macrolide-susceptible strains before treatment with azithromycin (1.5 g, n = 46; 1 g single oral dose, n = 10), 54 (96%) had a negative PCR test within 8 days. In four patients, M. genitalium converted from macrolide susceptible to resistant after a 10 day lag time with negative tests (azithromycin 1.5 g, n = 3; 1 g single oral dose, n = 1). Moxifloxacin-treated subjects (n = 4) were PCR negative within 1 week. Six of eight (75%) remained positive despite doxycycline treatment.

CONCLUSIONS:

PCR for M. genitalium rapidly became negative after azithromycin treatment. Macrolide-resistant strains were detected after initially negative tests. Test of cure should be recommended no earlier than 3-4 weeks.

Place, publisher, year, edition, pages
Oxford University Press, 2015. Vol. 70, no 11, 3134-3140 p.
Keyword [en]
Mycoplasma genitalium, eradication, antibiotic resistance
National Category
Dermatology and Venereal Diseases
Identifiers
URN: urn:nbn:se:liu:diva-120684DOI: 10.1093/jac/dkv246ISI: 000368245500029PubMedID: 26283670OAI: oai:DiVA.org:liu-120684DiVA: diva2:847604
Funder
Medical Research Council of Southeast Sweden (FORSS)
Available from: 2015-08-20 Created: 2015-08-20 Last updated: 2016-02-09

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Falk, Lars
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Division of Neuro and Inflammation ScienceResearch & Development Unit in Local Health CareFaculty of Medicine and Health Sciences
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