The STI Clinic News > To Treat or Not to Treat
# Thursday, June 12, 2014
Posted: Thursday, June 12, 2014 | Categories: Mycoplasma Genitalium

One of the questions we get asked quite frequently is whether or not Mycoplasma Genitalium should be treated. The reason we get asked this question is that a number of people have been told by NHS staff that they do not test for this infection as it is very common and does not cause any problems if left untreated. This advice really flies in the face of most of the scientific evidence that we have to hand.

It is certainly true that many women who test positive for Mycoplasma Genitalium do not have any outward symptoms but there is an association between Mycoplasma Genitalium and tubal factor infertility. Many women do of course have outward symptoms and are not offered the right treatment as Mycoplasma has not been detected by the NHS so the patient is given a course of treatment that we know through clinical experience and controlled studies to be not the optimum choice.

The vast majority of men who test positive for Mycoplasma Genitalium do have symptoms and are normally diagnosed with NSU by the NHS. Again, this can lead to the prescription of a sub-optimal course of treatment.

Our recommendation is that the front line treatment for Mycoplasma Genitalium should be a 5 day course of Azithromycin, with 500 mg on day one and the four subsequent doses of 250 mg. This produces the highest cure rate of all the non-quinolone medications. If this treatment fails (and we have not had one single case where it has failed) then we would recommend a course of Moxifloxacin.

You can read more about Mycoplasma Genitalium here.


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