The efficacy of azithromycin for the treatment of genital mycoplasma genitalium: A systematic review and meta-analysis

Clinical Infectious Diseases

Volumn 61, Issue 9, 2015, Pages 1389-1399

  Lau, Andrew ^a   Bradshaw, Catriona S ^a,b,c   Lewis, Dyani ^a   Fairley, Christopher K ^b,c   Chen, Marcus Y ^b,c   Kong, Fabian Y S ^a   Hocking, Jane S ^a  

^a UNIVERSITY OF MELBOURNE   (Australia)

^b ALFRED HOSPITAL   (Australia)

^c MONASH UNIVERSITY   (Australia)

Author keywords

azithromycin; Mycoplasma genitalium; systematic review; treatment efficacy

Indexed keywords

AZITHROMYCIN; ANTIINFECTIVE AGENT;

ANTIBIOTIC THERAPY; ARTICLE; CONTROLLED CLINICAL TRIAL (TOPIC); DRUG EFFICACY; FOLLOW UP; GENITAL TRACT INFECTION; HUMAN; META ANALYSIS; MYCOPLASMA GENITALIUM; NONHUMAN; PRIORITY JOURNAL; RANDOMIZED CONTROLLED TRIAL (TOPIC); SYSTEMATIC REVIEW; TREATMENT DURATION; UROGENITAL TRACT INFECTION; ADOLESCENT; ADULT; AGED; CHILD; FEMALE; ISOLATION AND PURIFICATION; MALE; MICROBIOLOGY; MIDDLE AGED; MYCOPLASMA INFECTIONS; REPRODUCTIVE TRACT INFECTIONS; TREATMENT OUTCOME; VERY ELDERLY; YOUNG ADULT;

ADOLESCENT; ADULT; AGED; AGED, 80 AND OVER; ANTI-BACTERIAL AGENTS; AZITHROMYCIN; CHILD; FEMALE; HUMANS; MALE; MIDDLE AGED; MYCOPLASMA GENITALIUM; MYCOPLASMA INFECTIONS; REPRODUCTIVE TRACT INFECTIONS; TREATMENT OUTCOME; YOUNG ADULT;

EID: 84946723298     PISSN: 10584838     EISSN: 15376591     Source Type: Journal    
DOI: 10.1093/cid/civ644     Document Type: Article

References (56)

1. Taylor-Robinson D, Jensen JS. Mycoplasma genitalium: from chrysalis to multicolored butterfly. Clin Microbiol Rev 2011; 24:498-514.
2. Manhart LE, Critchlow CW, Holmes KK, et al. Mucopurulent cervicitis and Mycoplasma genitalium. J Infect Dis 2003; 187:650-7.
3. Cohen CR, Manhart LE, Bukusi EA, et al. Association between Mycoplasma genitalium and acute endometritis. Lancet 2002; 359:765-6.
4. Haggerty CL. Evidence for a role of Mycoplasma genitalium in pelvic inflammatory disease. Curr Opin Infect Dis 2008; 21:65-9.
5. Clausen HF, Fedder J, Drasbek M, et al. Serological investigation of Mycoplasma genitalium in infertile women. Hum Reprod 2001; 16:1866-74.
6. Svenstrup HF, Fedder J, Kristoffersen SE, Trolle B, Birkelund S, Christiansen G. Mycoplasma genitalium, Chlamydia trachomatis, and tubal factor infertility-A prospective study. Fertil Steril 2008; 90:513-20.
7. Walker J, Fairley CK, Bradshaw CS, et al. Mycoplasma genitalium incidence, organism load, and treatment failure in a cohort of young Australian women. Clin Infect Dis 2013; 56:1094-100.
8. Svenstrup HF, Dave SS, Carder C, et al. A cross-sectional study of Mycoplasma genitalium infection and correlates in women undergoing population-based screening or clinic-based testing for chlamydia infection in London. BMJ Open 2014; 4.
9. Oakeshott P, Aghaizu A, Hay P, et al. Is Mycoplasma genitalium in women the ?new chlamydia A community-based prospective cohort study. Clin Infect Dis 2010; 51:1160-6.
10. Jensen AJ, Kleveland CR, Moghaddam A, Haaheim H, Hjelmevoll SO, Skogen V. Chlamydia trachomatis, Mycoplasma genitalium and Ureaplasma urealyticum among students in northern Norway. J Eur Acad Dermatol 2013; 27:e91-6.
11. Baczynska A, Hvid M, Lamy P, Birkelund S, Christiansen G, Fedder J. Prevalence of mycoplasma genitalium, Mycoplasma hominis and Chlamydia trachomatis among Danish patients requesting abortion. Syst Biol Reprod Med 2008; 54:127-34.
12. Anderson B, Sokolowski I, Ostergaard L, Moller JK, Olesen F, Jensen JS. Mycoplasma genitalium: prevalence and behavioural risk factors in the general population. Sex Transm Infect 2007; 83:5.
13. Manhart LE, Holmes K, Hughes JP, Houston LS, Totten PA. Mycoplasma genitalium among young adults in the United States: an emerging sexually transmitted infection. Am J Public Health 2007; 97:8.
14. Centers for Disease Control and Prevention. Sexually transmitted diseases treatment guidelines, 2010. Morb Mortal Wkly Rep 2010; 59:40-4.
15. AustralasianSexual Health Alliance . Australian STI management guidelines for use in primary care. Available at: http://www.sti.guidelines.org.au/sexually-Dransmissible-infections/mycoplasma-genitalium#management. Accessed 1 July 2015.
16. Bradshaw CS, Jensen JS, Tabrizi SN, et al. Azithromycin failure in Mycoplasma genitalium urethritis. Emerg Infect Dis 2006; 12:1149-52.
17. Jensen JS, Bradshaw CS, Tabrizi SN, Fairley CK, Hamasuna R. Azithromycin treatment failure in Mycoplasma genitalium-positive patients with nongonococcal urethritis is associated with induced macrolide resistance. Clin Infect Dis 2008; 47:1546-53.
18. Chrisment D, Charron A, Cazanave C, Pereyre S, Bébéar C. Detection of macrolide resistance in Mycoplasma genitalium in France. J Antimicrob Chemother 2012; 67:2598-601.
19. Yew HS, Anderson T, Coughlan E. Letters to the editor induced macrolide resistance in Mycoplasma genitalium isolates from patients with recurrent nongonococcal urethritis. J Clin Microbiol 2011; 49:1695-6.
20. Gesink DC, Mulvad G, Montgomery-Andersen R, et al. Mycoplasma genitalium presence, resistance and epidemiology in Greenland. Int J Circumpolar Health 2012; 71:1-8.
21. Ito S, Shimada Y, Yamaguchi Y, et al. Selection of Mycoplasma genitalium strains harbouring macrolide resistance-Associated 23S rRNA mutations by treatment with a single 1 g dose of azithromycin. Sex Transm Infect 2011; 87:412-4.
22. Manhart LE, Broad JM, Golden MR. Mycoplasma genitalium: should we treat and how? Clin Infect Dis 2011; 53(suppl 3):S129-42.
23. Moher D, Liberati A, Tetzlaff J, Altman DG; PRISMA Group. Preferred reporting items for systematic reviews and meta-Analyses: the PRISMA statement. PLoS Med 2009; 6:e1000097.
24. Higgins JPT, Thompson SG, Deeks JJ, Altman DG. Measuring inconsistency in meta-Analyses. BMJ 2003; 327:557-60.
25. Sanderson S, ID IT, Higgins J. Tools for assessing quality and susceptibility to bias in observational studies in epidemiology: a systematic review and annotated bibliography. Int J Epidemiol 2007; 36:666-76.
26. Kissinger P, White S, Schmidt N, et al. Origins of repeat infections with Mycoplasma genitalium (Mg) among heterosexual men in two southern U.S. cities. Sex Transm Infect 2013; 89:A117.
27. Henning D, Eade D, Langstone A, Bean-Hodges A, Marceglia A, Azzopardi P. Asymptomatic Mycoplasma genitalium infection amongst marginalised young people accessing a youth health service in Melbourne. Int J STI AIDS 2014; 25:299-302.
28. Couldwell DL, Tagg KA, Jeoffreys NJ, Gilbert GL. Failure of moxifloxacin treatment in Mycoplasma genitalium infections due to macrolide and fluoroquinolone resistance. Int J STI AIDS 2013; 24:822-8.
29. Bissessor M, Tabrizi SN, Twin J, et al. Macrolide resistance and azithromycin failure in a Mycoplasma genitalium-infected cohort and response of azithromycin failures to alternative antibiotic regimens. Clin Infect Dis 2015; 60:1228-36.
30. Stamm WE, Batteiger BE, McCormack WM, et al. A randomized, double-blind study comparing single-dose rifalazil with single-dose azithromycin for the empirical treatment of nongonococcal urethritis in men. Sex Transm Dis 2007; 34:545-52.
31. Mena LA, Mroczkowski TF, Nsuami M, Martin DH. A randomized comparison of azithromycin and doxycycline for the treatment of Mycoplasma genitalium-positive urethritis in men. Clin Infect Dis 2009; 48:1649-54.
32. Schwebke JR, Rompalo A, Taylor S, et al. Re-evaluating the treatment of nongonococcal urethritis: emphasizing emerging pathogens-A randomized clinical trial. Clin Infect Dis 2011; 52:163-70.
33. Manhart LE, Gillespie CW, Lowens MS, et al. Standard treatment regimens for nongonococcal urethritis have similar but declining cure rates: a randomized controlled trial. Clin Infect Dis 2013; 56:934-42.
34. Bjrnelius E, Anagrius C, Bojs G, et al. Antibiotic treatment of symptomatic Mycoplasma genitalium infection in Scandinavia: a controlled clinical trial. Sex Transm Infect 2008; 84:72-6.
35. Gambini D, Decleva I, Lupica L, Ghislanzoni M, Cusini M, Alessi E. Mycoplasma genitalium in males with nongonococcal urethritis: prevalence and clinical efficacy of eradication. Sex Transm Dis 2000; 27:226-9.
36. Anagrius C, Lore B, Jensen JS. Treatment of Mycoplasma genitalium. Observations from a Swedish STD clinic. PLoS One 2013; 8:e61481.
37. Takahashi S, Matsukawa M, Kurimura Y, et al. Clinical efficacy of azithromycin for male nongonococcal urethritis. J Infect Chemother 2008; 14:409-12.
38. Wikstrom A, Jensen JS. Mycoplasma genitalium: a common cause of persistent urethritis among men treated with doxycycline. Sex Transm Infect 2006; 82:276-9.
39. Jernberg E, Moghaddam A, Moi H. Azithromycin and moxifloxacin for microbiological cure of Mycoplasma genitalium infection: an open study. Int J STD AIDS 2008; 19:676-9.
40. Bradshaw CS, Chen MY, Fairley CK. Persistence of Mycoplasma genitalium following azithromycin therapy. PLoS One 2008; 3:e3618.
41. Hagiwara N, Yasuda M, Maeda S-I, Deguchi T. In vitro activity of azithromycin against Mycoplasma genitalium and its efficacy in the treatment of male Mycoplasma genitalium-positive nongonococcal urethritis. J Infect Chemother 2011; 17:821-4.
42. Terada M, Izumi K, Ohki E, Yamagishi Y, Mikamo H. Antimicrobial efficacies of several antibiotics against uterine cervicitis caused by Mycoplasma genitalium. J Infect Chemother 2012; 18:313-7.
43. Daley GM, Russell DB, Tabrizi SN, Twin J, McBride WJ. Mycoplasma genitalium and its resistance to azithromycin in incarcerated men from far north Queensland. Sex Health 2014; 11:587-9.
44. Gundevia Z, Foster R, Jamil MS, McNulty A. Positivity at test of cure following first-line treatment for genital Mycoplasma genitalium: follow-up of a clinical cohort. Sex Transm Infect 2015; 91:11-3.
45. Kikuchi M, Ito S, Yasuda M, et al. Remarkable increase in fluoroquinolone-resistant Mycoplasma genitalium in Japan. J Antimicrob Chemother 2014; 69:2376-82.
46. Bissessor M, Tabrizi SN, Twin J, et al. Macrolide resistance and azithromycin failure in a Mycoplasma genitalium-infected cohort, and response of azithromycin failures to alternative antibiotic regimens. Clin Infect Dis 2015; 60:1228-36.
47. Twin J, Jensen JS, Bradshaw CS, et al. Transmission and selection of macrolide resistant Mycoplasma genitalium infections detected by rapid high resolution melt analysis. PLoS One 2012; 7:e35593.
48. Horner P. The case for further treatment studies of uncomplicated genital Chlamydia trachomatis infection. Sex Transm Infect 2006; 82:340-3.
49. Foulds G, Shepard RM, Johnson RB. The pharmacokinetics of azithromycin in human serum and tissues. J Antimicrob Chemother 1990; 25(suppl A):73-82.
50. Vodstrcil LA, McIvor R, Huston W, Tabrizi SN, Timms P, Hocking JS. The epidemiology of organism load in genital Chlamydia trachomatis infection-A systematic review. J Infect Dis 2015; 211:1628-45.
51. Jensen JS. Single-dose azithromycin treatment for Mycoplasma genitalium-positive urethritis: best but not good enough. Clin Infect Dis 2009; 48:1655-6.
52. Tagg KA, Jeoffreys NJ, Couldwell DL, Donald JA, Gilbert GL. Fluoroquinolone and macrolide resistance-Associated mutations in Mycoplasma genitalium. J Clin Microbiol 2013; 51:2245-9.
53. Shimada Y, Deguchi T, Nakane K, et al. Emergence of clinical strains of Mycoplasma genitalium harbouring alterations in ParC associated with fluoroquinolone resistance. Int J Antimicrob Agents 2010; 36:4.
54. Salado-Rasmussen K, Jensen JS. Mycoplasma genitalium testing pattern and macrolide resistance: a Danish nationwide retrospective survey. Clin Infect Dis 2014; 59:24-30.
55. World Health Organization. Guidelines for the management of sexually transmitted infections. Geneva, Switzerland: WHO, 2003.
56. Horner P, Blee K, Adams E. Time to manage Mycoplasma genitalium as an STI: but not with azithromycin 1 g! Curr Opin Infect Dis 2014; 27:68-74.