ArticleFrontiers in cellular and infection microbiology2026
Towards precision management of
Article in Frontiers in cellular and infection microbiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: The management of Methods: We conducted a retrospective cohort study at a tertiary hospital in China (2018-2024). Sexually active adults with nucleic acid amplification test (NAAT)-confirmed MG infection and available treatment records were included. The primary outcomes were treatment failure (persistent infection at 8 weeks, ultimate failure) and recurrence. Multivariable logistic regression and Kaplan-Meier survival analyses were employed to assess the impact of initial antibiotic regimens (azithromycin, quinolones, doxycycline-quinolone sequential therapy), demographics, and co-infections. Results: Among 1, 192 MG-positive patients, 474 completed follow-up. After adjustment, doxycycline-quinolone sequential therapy was associated with significantly lower odds of ultimate treatment failure (adjusted odds ratio [aOR]=0.36, 95%CI:0.21-0.61) and recurrence (aOR=0.37, 95%CI:0.18-0.75) compared to azithromycin. Survival analysis confirmed a faster median time to clearance with sequential therapy (7 vs. 10 weeks, p=0.001) and a marked "long-tail" effect in the azithromycin group (mean clearance time: 94.2 vs. 28.0 weeks). Co-infection with Conclusions: In this real-world cohort, doxycycline-quinolone sequential therapy demonstrated superior long-term effectiveness over azithromycin for MG infection. CT co-infection and male sex were key risk predictors. These findings advocate for a paradigm shift towards risk-stratified initial therapy, prioritizing sequential regimens for high-risk patients to improve cure rates while supporting antimicrobial stewardship.
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