ArticleThe Journal of antimicrobial chemotherapy2025
Efficacy and tolerability of the combination of minocycline and metronidazole for macrolide-resistant Mycoplasma genitalium.
Article in The Journal of antimicrobial chemotherapy, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
What it found
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Who cites it
5 citing papers in PubMed.
- Declining Efficacy of Moxifloxacin for Mycoplasma genitalium Infection: Time for Fluoroquinolone Resistance-Guided Therapy?The Journal of infectious diseases · 2026Article
- Case Report: First In-Human Report of Cure of RefractoryOpen forum infectious diseases · 2026Article
- Treatment Approaches for RefractoryOpen forum infectious diseases · 2026Article
- Drug resistance ofFrontiers in cellular and infection microbiology · 2026Review
- Mycoplasma Genitalium - Where are we at?Current HIV/AIDS reports · 2025Review
Corrections and comments
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Authors and funding
8 authors.
Funding
Abstract
BACKGROUND AND
objectivesCuring Mycoplasma genitalium is challenging in the context of rising antimicrobial resistance and limited therapeutic options. There is an urgent need for globally relevant and effective treatment options using readily available and affordable agents. From September 2021 to August 2024 at Melbourne Sexual Health Centre, we prospectively evaluated microbial cure and tolerability of oral minocycline 100 mg combined with metronidazole 400 mg (twice daily for 14 days) for individuals with macrolide-resistant M. genitalium in whom fluroquinolones had failed or were not advised.
methodsMicrobial cure was defined as a negative test of cure (TOC) using transcription-mediated amplification 14-90 days after completing the regimen. The proportion cured and 95% confidence intervals (CIs) were calculated. Data on side effects and adherence were collected at TOC visits.
resultsMicrobial cure in patients receiving the combination regimen was 80.8% (95% CI: 71.9-87.8%). Cure in those who had received preceding doxycycline was 90.3% (n = 28/31, 95% CI: 74.2-98.0%) compared to 76.7% (n = 56/73, 95% CI: 65.4-85.8%) in those who had not, P = 0.172. Central nervous system and gastrointestinal side effects were commonly reported.
conclusionsMinocycline with metronidazole cured 80% of macrolide-resistant infections in this cohort. Cure may be enhanced by the use of doxycycline before the combination regimen but larger studies are needed. Given limited options for treating resistant M. genitalium infections, the combined minocycline and metronidazole regimen may represent a promising option where no alternative drugs are available, or quinolones are contraindicated. Clinicians should be aware of and discuss side effects with patients.
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