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Treatment of Mycoplasma genitalium. Observations from a Swedish STD Clinic

OBJECTIVES: To evaluate therapy for Mycoplasma genitalium infection with doxycycline or azithromycin 1 g compared to five days of azithromycin (total dose 1.5 g). METHODS: A retrospective case study was performed among patients attending the STD-clinic in Falun, Sweden 1998–2005. All patients with a...

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Autores principales: Anagrius, Carin, Loré, Britta, Jensen, Jørgen Skov
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3620223/
https://www.ncbi.nlm.nih.gov/pubmed/23593483
http://dx.doi.org/10.1371/journal.pone.0061481
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author Anagrius, Carin
Loré, Britta
Jensen, Jørgen Skov
author_facet Anagrius, Carin
Loré, Britta
Jensen, Jørgen Skov
author_sort Anagrius, Carin
collection PubMed
description OBJECTIVES: To evaluate therapy for Mycoplasma genitalium infection with doxycycline or azithromycin 1 g compared to five days of azithromycin (total dose 1.5 g). METHODS: A retrospective case study was performed among patients attending the STD-clinic in Falun, Sweden 1998–2005. All patients with a positive PCR test for M. genitalium were routinely offered a test of cure (toc). Response to doxycycline for 9 days, azithromycin 1 g single dose and extended azithromycin (500 mg on day 1 followed by 250 mg o.d. for 4 days) was determined. In patients with treatment failure after azithromycin, macrolide resistance was monitored before and after treatment. Furthermore, the rate of macrolide resistance was monitored for positive specimens available from 2006–2011. RESULTS: The eradication rate after doxycycline was 43% (48% for women and 38% for men), for azithromycin 1 g 91% (96% for women and 88% for men) and for extended azithromycin 99% (100% for women and 93% for men). Macrolide resistance developed in 7/7 examined (100%) of those testing positive after azithromycin 1 g, but in none of those treated with extended azithromycin. Macrolide resistance before treatment increased from 0% in 2006 and 2007 to 18% in 2011. CONCLUSIONS: These findings confirm the results from other studies showing that doxycycline is inefficient in eradicating M. genitalium. Although azithromycin 1 g was not significantly less efficient than extended dosage, it was associated with selection of macrolide resistant M. genitalium strains and should not be used as first line therapy for M. genitalium. Monitoring of M. genitalium macrolide resistance should be encouraged.
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spelling pubmed-36202232013-04-16 Treatment of Mycoplasma genitalium. Observations from a Swedish STD Clinic Anagrius, Carin Loré, Britta Jensen, Jørgen Skov PLoS One Research Article OBJECTIVES: To evaluate therapy for Mycoplasma genitalium infection with doxycycline or azithromycin 1 g compared to five days of azithromycin (total dose 1.5 g). METHODS: A retrospective case study was performed among patients attending the STD-clinic in Falun, Sweden 1998–2005. All patients with a positive PCR test for M. genitalium were routinely offered a test of cure (toc). Response to doxycycline for 9 days, azithromycin 1 g single dose and extended azithromycin (500 mg on day 1 followed by 250 mg o.d. for 4 days) was determined. In patients with treatment failure after azithromycin, macrolide resistance was monitored before and after treatment. Furthermore, the rate of macrolide resistance was monitored for positive specimens available from 2006–2011. RESULTS: The eradication rate after doxycycline was 43% (48% for women and 38% for men), for azithromycin 1 g 91% (96% for women and 88% for men) and for extended azithromycin 99% (100% for women and 93% for men). Macrolide resistance developed in 7/7 examined (100%) of those testing positive after azithromycin 1 g, but in none of those treated with extended azithromycin. Macrolide resistance before treatment increased from 0% in 2006 and 2007 to 18% in 2011. CONCLUSIONS: These findings confirm the results from other studies showing that doxycycline is inefficient in eradicating M. genitalium. Although azithromycin 1 g was not significantly less efficient than extended dosage, it was associated with selection of macrolide resistant M. genitalium strains and should not be used as first line therapy for M. genitalium. Monitoring of M. genitalium macrolide resistance should be encouraged. Public Library of Science 2013-04-08 /pmc/articles/PMC3620223/ /pubmed/23593483 http://dx.doi.org/10.1371/journal.pone.0061481 Text en © 2013 Anagrius et al http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited.
spellingShingle Research Article
Anagrius, Carin
Loré, Britta
Jensen, Jørgen Skov
Treatment of Mycoplasma genitalium. Observations from a Swedish STD Clinic
title Treatment of Mycoplasma genitalium. Observations from a Swedish STD Clinic
title_full Treatment of Mycoplasma genitalium. Observations from a Swedish STD Clinic
title_fullStr Treatment of Mycoplasma genitalium. Observations from a Swedish STD Clinic
title_full_unstemmed Treatment of Mycoplasma genitalium. Observations from a Swedish STD Clinic
title_short Treatment of Mycoplasma genitalium. Observations from a Swedish STD Clinic
title_sort treatment of mycoplasma genitalium. observations from a swedish std clinic
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3620223/
https://www.ncbi.nlm.nih.gov/pubmed/23593483
http://dx.doi.org/10.1371/journal.pone.0061481
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