Department of Urology, Graduate School of Medicine, Gifu University, Gifu, Japan.
Expert Rev Anti Infect Ther. 2012 Jul;10(7):791-803. doi: 10.1586/eri.12.38.
Mycoplasma genitalium is an important pathogen of acute non-gonococcal urethritis (NGU) in men and plays a significant role in persistent or recurrent NGU. In the management of patients with M. genitalium-positive NGU, eradication of the mycoplasma from the urethra is necessary to prevent persistent or recurrent NGU. Therefore, M. genitalium should be considered for antimicrobial chemotherapy of NGU. This article reviews the in vitro antimicrobial activities of antibiotics against M. genitalium and the efficacies of various antibiotic regimens against M. genitalium-positive NGU, including the doxycycline and azithromycin regimens recommended as first-line treatments for NGU in the guidelines. Selection of macrolide-resistant M. genitalium by treatment with the single-dose regimen of 1-g azithromycin and mechanisms of macrolide resistance in M. genitalium are discussed. The effectiveness of the moxifloxacin regimen against persistent or recurrent NGU, unsuccessfully treated with azithromycin and/or doxycycline regimens, is emphasized.
生殖支原体是男性急性非淋球菌性尿道炎（NGU）的重要病原体，在持续性或复发性 NGU 中起重要作用。在治疗生殖支原体阳性 NGU 患者时，必须从尿道清除支原体，以预防持续性或复发性 NGU。因此，应考虑针对 NGU 进行生殖支原体的抗菌化学疗法。本文综述了抗生素对生殖支原体的体外抗菌活性以及各种抗生素方案治疗生殖支原体阳性 NGU 的疗效，包括作为 NGU 指南中一线治疗推荐的多西环素和阿奇霉素方案。讨论了 1 克阿奇霉素单剂量方案治疗选择耐大环内酯类的生殖支原体以及生殖支原体中耐大环内酯类的机制。强调了莫西沙星方案对阿奇霉素和/或多西环素方案治疗不成功的持续性或复发性 NGU 的疗效。
