{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T16:20:50Z","timestamp":1788366050740,"version":"build-2803163510"},"reference-count":27,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2026,5,17]],"date-time":"2026-05-17T00:00:00Z","timestamp":1778976000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,9,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Mycoplasma genitalium (MG) is increasingly characterized by high rates of macrolide and fluoroquinolone resistance. International guidelines recommend resistance-guided therapy; however, access to genotypic testing is limited, and randomized trial evidence is lacking. We assessed the efficacy of moxifloxacin and azithromycin without resistance assays.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This monocentric, open-label, superiority, randomized controlled trial enrolled adults with MG infection detected by multiplex PCR, randomized 1:1 to receive moxifloxacin 400 mg daily for 10 days or azithromycin 500 mg daily for 6 days. A test of cure was performed \u226528 days after treatment completion. The primary endpoint was microbiological cure in the intention-to-treat (ITT) and per-protocol (PP) populations. Subgroup analyses assessed symptomatic versus asymptomatic infections, doxycycline exposure, re-treatment, and sexual behavior.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 358 randomized participants, 87.0% of those treated with moxifloxacin and 61.2% of those treated with azithromycin achieved microbiological cure in the ITT analysis (absolute risk difference 25.8%, 95% CI 16.5, 35.2). The superiority of moxifloxacin was confirmed in the ITT and PP populations. Moxifloxacin remained superior across most subgroups, whereas azithromycin showed comparable efficacy only among heterosexual individuals. Doxycycline coadministration did not improve outcomes. Both regimens were well tolerated, with only one case of discontinuation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Moxifloxacin demonstrated superior efficacy compared to azithromycin for treating MG infection in the absence of resistance testing. These randomized data support the use of moxifloxacin as a first-line option when resistance assays are unavailable and may inform treatment strategies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/cid\/ciag317","type":"journal-article","created":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T12:04:47Z","timestamp":1778760287000},"page":"276-284","source":"Crossref","is-referenced-by-count":0,"title":["A Randomized Clinical Trial to Compare Moxifloxacin Versus Azithromycin for the Treatment of\n                    <i>Mycoplasma genitalium<\/i>\n                    : The FARTHEST Study"],"prefix":"10.1093","volume":"83","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4965-8789","authenticated-orcid":false,"given":"Roberto","family":"Rossotti","sequence":"first","affiliation":[{"name":"Department of Infectious Diseases, ASST Grande Ospedale Metropolitano Niguarda , Milan ,","place":["Italy"]},{"name":"Department of Diagnostics and Public Health, University of Verona , Verona ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chiara","family":"Baiguera","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, ASST Grande Ospedale Metropolitano Niguarda , Milan ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8771-5428","authenticated-orcid":false,"given":"Davide Paolo","family":"Bernasconi","sequence":"additional","affiliation":[{"name":"Bicocca Bioinformatics Biostatistics and Bioimaging Center B4, University of Milano-Bicocca , Milan ,","place":["Italy"]},{"name":"Department of Research Innovation and Technology Transfer, ASST Grande Ospedale Metropolitano Niguarda , Milan ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas Brian","family":"Bana","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, ASST Grande Ospedale Metropolitano Niguarda , Milan ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8891-623X","authenticated-orcid":false,"given":"Alice","family":"Nava","sequence":"additional","affiliation":[{"name":"Clinical Microbiology, ASST Grande Ospedale Metropolitano Niguarda , Milan ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-9373-0705","authenticated-orcid":false,"given":"Gabriele","family":"Cavazza","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, ASST Grande Ospedale Metropolitano Niguarda , Milan ,","place":["Italy"]},{"name":"School of Medicine and Surgery, University of Milano-Bicocca , Milan ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giulia Jole","family":"Burastero","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, ASST Grande Ospedale Metropolitano Niguarda , Milan ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leonardo Francesco","family":"Rezzonico","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, ASST Grande Ospedale Metropolitano Niguarda , Milan ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"Simoncini","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, ASST Grande Ospedale Metropolitano Niguarda , Milan ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisa","family":"Di Gennaro","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, ASST Grande Ospedale Metropolitano Niguarda , Milan ,","place":["Italy"]},{"name":"School of Medicine and Surgery, University of Milano-Bicocca , Milan ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-8014-4711","authenticated-orcid":false,"given":"Leonardo","family":"Luzi","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, ASST Grande Ospedale Metropolitano Niguarda , Milan ,","place":["Italy"]},{"name":"School of Medicine and Surgery, University of Milano-Bicocca , Milan ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diana","family":"Fanti","sequence":"additional","affiliation":[{"name":"Clinical Microbiology, ASST Grande Ospedale Metropolitano Niguarda , Milan ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4206-0066","authenticated-orcid":false,"given":"Giovanna","family":"Travi","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, ASST Grande Ospedale Metropolitano Niguarda , Milan 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