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Positivity at test of cure following first-line treatment for genital Mycoplasma genitalium: follow-up of a clinical cohort
  1. Zarin Gundevia1,
  2. Rosalind Foster1,2,
  3. Muhammad Shahid Jamil2,
  4. Anna McNulty1,3
  1. 1Department of Sexual Health Medicine, Sydney Sexual Health Centre, Sydney, Australia
  2. 2The Kirby Institute, University of New South Wales, Sydney, Australia
  3. 3School of Public Health and Community Medicine, University of New South Wales, Sydney, Australia
  1. Correspondence to Dr Zarin Gundevia, Level 3, Nightingale Wing, Sydney Sexual Health Centre, Sydney/Sydney Eye Hospital, Macquarie Street, Sydney, NSW 2000, Australia; zarin{at}


Objectives To describe antibiotic use for treatment of Mycoplasma genitalium (MG) at an urban sexual health centre in Australia. To describe MG positivity rates in those returning for 1 month test of cure (TOC) following first-line antibiotic treatment for MG.

Methods Retrospective cross-sectional case-note review for all patients diagnosed with MG at Sydney Sexual Health Centre from 2009 to 2013.

Results Two hundred and eighteen MG cases were identified; 66% were male and 90% were symptomatic at presentation. Four people did not return for treatment. Azithromycin containing regimens were prescribed as first-line treatment in 88% of cases; azithromycin 1 g stat in 75% of cases and a course of extended azithromycin 1 g stat plus 500 mg daily for 4 days in 14% of cases. TOC was performed in 53% (95% CI 46% to 60%) of cases and 28% (95% CI 20% to 38%) of these cases were MG-positive at TOC. Of those having a MG-positive result at TOC, 26% received azithromycin 1 g stat and 33% received extended azithromycin. Accounting for cases lost to follow-up in azithromycin containing regimens, the positive MG TOC rate was estimated to be between 15% and 61%.

Conclusions High rates of MG positivity were found in those attending TOC following first-line treatment of MG with azithromycin containing regimens.


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