Efficacy of azithromycin in treating Ureaplasma urealyticum: a systematic review and meta-analysis

BACKGROUND: Ureaplasma urealyticum is the most prevalent genital mycoplasma isolated from the urogenital tract of females, but there is no unified treatment plan. This study aimed to evaluate the efficacy of azithromycin in treating Ureaplasma urealyticum. METHODS: From the earliest to June 2022, published randomized controlled trials (RCTs) on azithromycin treatment of Ureaplasma urealyticum were retrieved by searching PubMed, Embase, Cochrane Library, and Web of Science. Two reviewers independently extracted the data. We utilized the Cochrane risk-of-bias assessment technique to assess the quality of included RCTs. The data were analyzed using the R language (version 4.0.4) software. RESULTS: Seven RCTs were finally included, involving 512 participants (240 in the experimental group, 272 in the control group). The experimental group was treated with azithromycin monotherapy, while the control group was treated with doxycycline or a placebo. Meta-analysis results suggested that azithromycin has a comparable therapeutic effect on Ureaplasma urealyticum in comparison to that of controls (risk ratio [RR] = 1.03, 95% confidence interval [CI] 0.94–1.12). Subgroup analysis showed that the dose and duration of azithromycin may don’t affect its efficacy. CONCLUSION: Regarding the meta-analysis that we performed based on existing clinical studies, azithromycin is quite effective in treating Ureaplasma urealyticum. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12879-023-08102-5.