Mycoplasmenurethritis N34.2

Urogenital mycoplasma:

• Ureaplasma urealyticum (60%)
• Mycoplasma hominis (20%)
• Mycoplasma genitalium (15%)
• Mycoplasma fermans (3%)

• For uncomplicated infection with Mycoplasma genitalium: Azithromycin 500 day 1, then 250 mg day 2-5. For treatment failure or complicated infection Moxifloxacin 400 mg 1 x tgl 7-14 days, 3rd choice due to resistance Doxycycline (e.g. Doxycycline Heumann 100) 2 times/day 100 mg for 7-10 days.
• For infection with Ureaplasma urealytic: doxycycline (e.g. Doxycyclin Heumann 100) 2 times/day 100 mg for 7-10 days. Alternatively: Ofloxacin (e.g. Tavanic 200 Filmtbl.) 2 times/day 200 mg for 7 days or Erythromycin (e.g. Erythromycin Stada) 3 times/day 500 mg for 10 days.
• Partner treatment!

Caveat. Because of the cell wall-less nature of mycoplasmas, there is resistance to cell wall-active antibiotics (e.g., penicillins, cephalosporins) and cell wall-active enzymes. Approximately 10% of ureaplasmas are resistant to tetracyclines, 40% of which are also simultaneously resistant to erythromycin.

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6. Taylor-Robinson D et al (2003) Detection of several Mycoplasma species at various anatomical sites of homosexual men. Eur J Clin Microbiol Infect Dis 22: 291-293