J Am Pharm Assoc (2003). 2024 Jan-Feb;64(1):295-300.e3. doi: 10.1016/j.japh.2023.10.007. Epub 2023 Oct 14.
Mycoplasma genitalium is a sexually transmitted infection (STI) increasing in prevalence. The recent availability of nucleic acid amplification tests (NAATs) has led to updated diagnostic and treatment guidelines. As medication therapy experts, pharmacists can facilitate appropriate antimicrobial selection and stewardship and optimize best patient-care practices in the setting of M. genitalium infection.
This study aimed to evaluate patient demographics, therapeutic approaches, and complications of patients with laboratory evidence of M. genitalium hypothesizing that younger adolescent females are affected by this organism, receive suboptimal treatment, and have more complications than adults.
This was a retrospective cohort study using TriNetX multicenter electronic health record data of subjects aged 12 years and older with evidence of M. genitalium DNA detected via NAATs. The cohort was divided into 2 age groups: adolescents (12-21 years) and adults (older than 21 years). We evaluated age, sex, race, ethnicity, diagnostic codes, and medication codes.
Our study included 1126 subjects (192 adolescents [17.1%] and 934 adults [82.9%]) who tested positive for M. genitalium. Subjects in the adolescent group had higher odds of being women (2.52 [1.80, 3.54], P < 0.001), having inflammatory diseases of female pelvic organs diagnostic codes (1.51 [1.06, 2.16], P = 0.025), increased odds of azithromycin prescription (1.70 [1.17, 2.48], P = 0.005), and decreased odds of moxifloxacin prescription (0.41 [0.26, 0.64], P < 0.001).
Our study revealed a higher prevalence of M. genitalium infection in adults and adolescents with increased odds of receiving azithromycin and decreased odds of receiving moxifloxacin. Both age groups had decreased odds of receiving doxycycline compared with azithromycin despite guidelines recommending initial empirical antibiotic treatment with doxycycline and growing macrolide resistance. Suboptimal treatment of this infection may lead to lifelong complications. Pharmacists may provide crucial guidance and education to both patients and health care providers regarding appropriate treatment for M. genitalium.
支原体生殖器是一种性传播感染（STI），其流行率正在上升。核酸扩增检测（NAATs）的最新可用性导致了更新的诊断和治疗指南。作为药物治疗专家，药剂师可以促进适当的抗菌药物选择和管理，并在支原体生殖器感染的情况下优化最佳患者护理实践。
本研究旨在评估实验室证据显示患有支原体生殖器感染的患者的人口统计学特征、治疗方法和并发症，假设年轻的青少年女性更容易受到这种病原体的影响，接受的治疗不理想，并且比成年人更容易出现并发症。
这是一项使用 TriNetX 多中心电子健康记录数据的回顾性队列研究，该数据来自年龄在 12 岁及以上且通过 NAATs 检测到支原体生殖器 DNA 的受试者。该队列分为 2 个年龄组：青少年（12-21 岁）和成年人（21 岁以上）。我们评估了年龄、性别、种族、民族、诊断代码和药物代码。
我们的研究包括 1126 名受试者（192 名青少年[17.1%]和 934 名成年人[82.9%]），他们的支原体生殖器检测结果呈阳性。青少年组的受试者更有可能是女性（2.52 [1.80, 3.54]，P < 0.001），患有女性盆腔器官炎症性疾病诊断代码的可能性更高（1.51 [1.06, 2.16]，P = 0.025），更有可能开具阿奇霉素处方（1.70 [1.17, 2.48]，P = 0.005），而开具莫西沙星处方的可能性较低（0.41 [0.26, 0.64]，P < 0.001）。
我们的研究表明，成人和青少年中支原体生殖器感染的流行率较高，使用阿奇霉素的几率增加，而使用莫西沙星的几率降低。尽管指南建议初始经验性抗生素治疗使用多西环素，并且大环内酯类药物的耐药性正在增加，但这两个年龄组使用多西环素的几率均低于阿奇霉素。这种感染的治疗不理想可能会导致终生并发症。药剂师可以为患者和医疗保健提供者提供有关支原体生殖器感染适当治疗的重要指导和教育。
