Azithromycin and moxifloxacin for microbiological cure of Mycoplasma genitalium infection: an open study.

There are no evidence-based guidelines for the treatment of Mycoplasma genitalium-positive genital infection. In a retrospective survey, we analysed the treatment results of patients tested for M. genitalium at Olafia, Unit for Sexual Transmitted Diseases in Oslo. Out of 10,109 patients, 452 had a positive polymerase chain reaction. Between 72% and 100% of patients in the different treatment groups returned for test of cure after four to five weeks. First-line treatment with 1 g single dose azithromycin had a recovery rate of 79%. It was as effective as an extended five-days' course of azithromycin. Ofloxacin 200 mg b.i.d for 10 days cured 56% and moxifloxacin 400 mg o.d. for seven days as either second-, third- or fourth-line treatment after azithromycin or ofloxacin failure cured 100%. Azithromycin 1 g as a single dose seems to be the best choice of treatment for M. genitalium, with moxifloxacin 400 mg x 1 for seven days if treatment fails.