ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2019
Outcomes of Resistance-guided Sequential Treatment of Mycoplasma genitalium Infections: A Prospective Evaluation.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 76 papers, 2 of them syntheses that pooled it.
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Who cites it
76 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- German evidence- and consensus-based guideline on the management of penile urethritis.Journal der Deutschen Dermatologischen Gesellschaft = Journal of the German Society of Dermatology : JDDG · 2025Guideline
- Sexually Transmitted Infections Treatment Guidelines, 2021.MMWR. Recommendations and reports : Morbidity and mortality weekly report. Recommendations and reports · 2021Guideline
- Declining Efficacy of Moxifloxacin for Mycoplasma genitalium Infection: Time for Fluoroquinolone Resistance-Guided Therapy?The Journal of infectious diseases · 2026Article
- Antimicrobial resistance crisis in STIs: Gonorrhea andNew microbes and new infections · 2026Review
- A Prospective Incidence Study on Sexually Transmitted Infections and HIV in Men Who Have Sex With Men, With or Without Use of Pre-exposure Prophylaxis.Open forum infectious diseases · 2026Article
- The Role of Antimicrobial Susceptibility and Resistance Testing forOpen forum infectious diseases · 2026Article
- Treatment Approaches for RefractoryOpen forum infectious diseases · 2026Article
- Prevalence and Distribution of Antimicrobial Resistance-Associated Mutations inMicroorganisms · 2026Article
- Systematic Review and Meta-analysis of the Association Between Mycoplasma genitalium and Pelvic Inflammatory Disease (PID).Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2026Article
- Cost of illness of Mycoplasma genitalium in Australia: an incidence-based approach incorporating resistance-guided therapy.Scientific reports · 2026Article
- Spread of dual-class drug-resistantAntimicrobial agents and chemotherapy · 2026Article
- Mathematical analysis of Mycoplasma Genitalium transmission dynamics: A compartmental model with nonlinear interactions and treatment effects.PLOS global public health · 2026Article
- Comparative Study of the Clinical Characteristics of Patients With Sexually Transmitted Infections Diagnosed by Nucleic Acid Amplification Tests.Journal of Korean medical science · 2025Article
- Mycoplasma Genitalium - Where are we at?Current HIV/AIDS reports · 2025Review
- In vitro evolution provides insights into mechanisms of Mycoplasma genitalium resistance to moxifloxacin.The Journal of antimicrobial chemotherapy · 2025Article
- The Current Landscape of Antibiotic Use and Antimicrobial Resistance in Japan: Focusing on Common Infections Including Uncomplicated Urinary Tract Infection and Gonorrhea.Antibiotics (Basel, Switzerland) · 2025Review
- Efficacy and tolerability of the combination of minocycline and metronidazole for macrolide-resistant Mycoplasma genitalium.The Journal of antimicrobial chemotherapy · 2025Article
- New Trends in Sexually Transmitted Infections Among Adolescents and Young People: Epidemiology, Clinical and Diagnostic Management.Microorganisms · 2025Review
- STI point-of care tests: a call for quality-assured evaluation, implementation, innovation, and investment in future technologies.BMC infectious diseases · 2025Article
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16 more citing papers are in PubMed but not listed here.
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Authors and funding
12 authors.
Funding
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Abstract
Background: Rising macrolide and quinolone resistance in Mycoplasma genitalium necessitate new treatment approaches. We evaluated outcomes of sequential antimicrobial therapy for M. genitalium guided by a macrolide-resistance assay. Methods: In mid-2016, Melbourne Sexual Health Centre switched from azithromycin to doxycycline (100 mg twice daily for 7 days) for nongonococcal urethritis, cervicitis, and proctitis. Cases were tested for M. genitalium and macrolide-resistance mutations (MRMs) by polymerase chain reaction. Directly after doxycycline, MRM-negative infections received 2.5 g azithromycin (1 g, then 500 mg daily for 3 days), and MRM-positive infections received sitafloxacin (100 mg twice daily for 7 days). Assessment of test of cure and reinfection risk occurred 14-90 days after the second antibiotic. Results: Of 244 evaluable M. genitalium infections (52 women, 68 heterosexual men, 124 men who have sex with men) diagnosed from 20 June 2016 to 15 May 2017, MRMs were detected in 167 (68.4% [95% confidence interval {CI}, 62.2%-74.2%]). Treatment with doxycycline decreased bacterial load by a mean 2.60 log10 (n = 56; P < .0001). Microbiologic cure occurred in 73 of 77 MRM-negative infections (94.8% [95% CI, 87.2%-98.6%]) and in 154 of 167 MRM-positive infections (92.2% [95% CI, 87.1%-95.8%]). Selection of macrolide resistance occurred in only 2 of 76 (2.6% [95% CI, .3%-9.2%]) macrolide-susceptible infections. Conclusions: In the context of high levels of antimicrobial resistance, switching from azithromycin to doxycycline for presumptive treatment of M. genitalium, followed by resistance-guided therapy, cured ≥92% of infections, with infrequent selection of macrolide resistance.
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