zithromax and Dysuria

Mycoplasma genitalium infection contributes to 10-35% of non-chlamydial non-gonococcal urethritis in men. In women, M. genitalium is associated with cervicitis and pelvic inflammatory disease (PID) in 10-25%. Transmission of M. genitalium occurs through direct mucosal contact.. Asymptomatic infections are frequent. In men, urethritis, dysuria and discharge predominate. In women, symptoms include vaginal discharge, dysuria or symptoms of PID - abdominal pain and dyspareunia. Symptoms are the main indication for diagnostic testing. Diagnosis is achievable only through nucleic acid amplification testing and must include investigation for macrolide resistance mutations.. Therapy for M .genitalium is indicated if M. genitalium is detected. Doxycycline has a cure rate of 30-40%, but resistance is not increasing. Azithromycin has a cure rate of 85-95% in macrolide-susceptible infections. An extended course of azithromycin appears to have a higher cure rate, and pre-treatment with doxycycline may decrease organism load and the risk of macrolide resistance selection. Moxifloxacin can be used as second-line therapy but resistance is increasing.. Uncomplicated M. genitalium infection without macrolide resistance mutations or resistance testing: Azithromycin 500 mg on day one, then 250 mg on days 2-5 (oral). Second-line treatment and treatment for uncomplicated macrolide-resistant M. genitalium infection: Moxifloxacin 400 mg od for 7 days (oral). Third-line treatment for persistent M. genitalium infection after azithromycin and moxifloxacin: Doxycycline or minocycline 100 mg bid for 14 days (oral) may cure 40-70%. Pristinamycin 1 g qid for 10 days (oral) has a cure rate of around 75%. Complicated M. genitalium infection (PID, epididymitis): Moxifloxacin 400 mg od for 14 days. MAIN CHANGES FROM THE 2016 EUROPEAN M.. Due to increasing antimicrobial resistance and warnings against moxifloxacin use, indications for testing and treatment have been narrowed to primarily involve symptomatic patients. The importance of macrolide resistance-guided therapy is emphasised.

Topics: Anti-Bacterial Agents; Azithromycin; Doxycycline; Drug Resistance, Bacterial; Dysuria; Female; Humans; Macrolides; Male; Moxifloxacin; Mycoplasma genitalium; Mycoplasma Infections; Urethritis

We report two cases of multidrug-resistant

Topics: Anti-Bacterial Agents; Azithromycin; Back Pain; Cambodia; Ceftriaxone; Drug Resistance, Multiple, Bacterial; Dysuria; France; Gonorrhea; Heterosexuality; Humans; Male; Microbial Sensitivity Tests; Multilocus Sequence Typing; Neisseria gonorrhoeae; Nucleic Acid Amplification Techniques; Travel; Treatment Outcome; Urethritis; Whole Genome Sequencing

Ureaplasma urealyticum is a bacterial species correlated with urethritis in healthy individuals and invasive infections in immunocompromised patients. We describe a 20-year-old female with a history of remote heart transplant on everolimus, mycophenolate, and rituximab presenting with progressive urinary tract symptoms, renal failure, and neurologic symptoms. An extensive workup ultimately identified U urealyticum infection, and the patient successfully recovered after a course of azithromycin and doxycycline.

Topics: Anti-Bacterial Agents; Azithromycin; Doxycycline; Dysuria; Female; Humans; Immunocompromised Host; Male; Nervous System Diseases; Pyelonephritis; Renal Insufficiency; Ureaplasma Infections; Ureaplasma urealyticum; Young Adult

Corynebacterium propinquum is usually considered part of the normal human oropharyngeal flora and is rarely responsible for clinical infection. We report here what seems to be the first case of acute purulent urethral discharge in a young Iranian man with urethritis acquired after orogenital contact. Attention should be devoted to less common nondiphtheriae Corynebacterium species for differential diagnosis.

Topics: Adult; Anti-Bacterial Agents; Azithromycin; Corynebacterium; Corynebacterium Infections; Drug Therapy, Combination; Dysuria; Humans; Male; Sexual Behavior; Treatment Outcome; Urethritis; Vancomycin