Mycoplasma genitalium: should we treat and how?

Clin Infect Dis. 2011 Dec;53 Suppl 3(Suppl 3):S129-42. doi: 10.1093/cid/cir702.


Mycoplasma genitalium is associated with acute and chronic urethritis in men. Existing data on infection in women are limited and inconsistent but suggest that M. genitalium is associated with urethritis, cervicitis, pelvic inflammatory disease, and possibly female infertility. Data are inconclusive regarding the role of M. genitalium in adverse pregnancy outcomes and ectopic pregnancy. Available data suggest that azithromycin is superior to doxycycline in treating M. genitalium infection. However, azithromycin-resistant infections have been reported in 3 continents, and the proportion of azithromycin-resistant M. genitalium infection is unknown. Moxifloxacin is the only drug that currently seems to uniformly eradicate M. genitalium. Detection of M. genitalium is hampered by the absence of a commercially available diagnostic test. Persons with persistent pelvic inflammatory disease or clinically significant persistent urethritis or cervicitis should be tested for M. genitalium, if possible. Infected persons who have not previously received azithromycin should receive that drug. Persons in whom azithromycin therapy fails should be treated with moxifloxicin.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Anti-Bacterial Agents / therapeutic use
  • Aza Compounds / therapeutic use
  • Azithromycin / therapeutic use
  • Doxycycline / therapeutic use
  • Drug Resistance, Bacterial
  • Female
  • Fluoroquinolones
  • Humans
  • Infertility, Female / etiology
  • Male
  • Moxifloxacin
  • Mycoplasma Infections / complications
  • Mycoplasma Infections / diagnosis*
  • Mycoplasma Infections / drug therapy*
  • Mycoplasma genitalium / isolation & purification*
  • Pelvic Inflammatory Disease / complications
  • Pelvic Inflammatory Disease / diagnosis
  • Pelvic Inflammatory Disease / drug therapy
  • Pelvic Inflammatory Disease / microbiology
  • Pregnancy
  • Pregnancy, Ectopic / etiology
  • Quinolines / therapeutic use
  • Treatment Outcome
  • Urethritis / diagnosis*
  • Urethritis / drug therapy*
  • Urethritis / microbiology
  • Uterine Cervicitis / complications
  • Uterine Cervicitis / diagnosis
  • Uterine Cervicitis / drug therapy
  • Uterine Cervicitis / microbiology


  • Anti-Bacterial Agents
  • Aza Compounds
  • Fluoroquinolones
  • Quinolines
  • Azithromycin
  • Doxycycline
  • Moxifloxacin