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- Title
The Efficacy of Azithromycin for the Treatment of Genital Mycoplasma genitalium: A Systematic Review and Meta-analysis.
- Authors
Lau, Andrew; Bradshaw, Catriona S.; Lewis, Dyani; Fairley, Christopher K.; Chen, Marcus Y.; Kong, Fabian Y. S.; Hocking, Jane S.
- Abstract
Background: Mycoplasma genitalium (MG) is associated with nongonococcal urethritis in men and cervicitis in women. Current guidelines recommend treatment with 1 gram of azithromycin; however, treatment failure has increasingly been reported. This meta-analysis estimates treatment efficacy following treatment with 1 gram of azithromycin. Methods. Electronic databases were searched for articles published to the end of February 2015 using the following search terms: (Mycoplasma genitalium)AND(azithromycinOR zithromaxOR[treatment efficacy]). Studieswere included if they were English language, had participants aged =12 years diagnosed with urogenital MG, and hadmicrobial cure measured within 12 months of treatment. Treatment efficacy was measured as microbial cure at last follow-up after treatment. Results. Atotal of 21 studies, including 1490 participants, fulfilled the inclusioncriteria.Most studieswere observational, with only 5 controlled trials identified. The random-effects pooled microbial curewas 77.2%(95% confidence interval [CI], 71.1%-83.4%; I² = 80.8%, P < .01). For the 12 studies conducted prior to 2009, pooled microbial curewas 85.3% (CI, 82.3%-88.3%; I² = 19.7%, P = .25); for the 9 studies conducted since the beginning of 2009, pooled microbial cure was 67.0% (CI, 57.0%-76.9%; I² = 80.9%, P < .01). Conclusions. The efficacy of a single dose of 1 gramof azithromycin for the treatment of urogenitalMGhas decreased to approach 60%.Even thoughmost of the available evidence is based on observational studies that have considerable variability in sample size and timing of microbial cure, this lowefficacy is of considerable concern. It is vital that newtreatment options for MG are investigated.
- Subjects
AZITHROMYCIN; MYCOPLASMA diseases; NONGONOCOCCAL urethritis; META-analysis; SYSTEMATIC reviews; TREATMENT effectiveness; THERAPEUTICS
- Publication
Clinical Infectious Diseases, 2015, Vol 61, Issue 9, p1389
- ISSN
1058-4838
- Publication type
Article
- DOI
10.1093/cid/civ644