{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T02:02:52Z","timestamp":1793325772235,"version":"4.5.0"},"reference-count":39,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2019,10,20]],"date-time":"2019-10-20T00:00:00Z","timestamp":1571529600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","award":["1091536"],"award-info":[{"award-number":["1091536"]}],"id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","award":["1091226"],"award-info":[{"award-number":["1091226"]}],"id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,9,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Macrolide resistance in Mycoplasma genitalium (MG) exceeds 50% in many regions, and quinolone resistance is increasing. We recently reported that resistance-guided therapy (RGT) using doxycycline followed by sitafloxacin or 2.5 g azithromycin cured 92% and 95% of macrolide-resistant and macrolide-susceptible infections, respectively. We present data on RGT using doxycycline\u2013moxifloxacin, the regimen recommended in international guidelines, and extend data on the efficacy of doxycycline\u20132.5 g azithromycin and de novo macrolide resistance.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Patients attending Melbourne Sexual Health Centre between 2017 and 2018 with sexually transmitted infection syndromes were treated with doxycycline for 7 days and recalled if MG-positive. Macrolide-susceptible cases received 2.5 g azithromycin (1 g, then 500 mg daily for 3 days), and resistant cases moxifloxacin (400 mg daily, 7 days). Test of cure was recommended 14\u201328 days post-antimicrobials.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>There were 383 patients (81 females\/106 heterosexual males\/196 men who have sex with men) included. Microbial cure following doxycycline\u2013azithromycin was 95.4% (95% confidence interval [CI], 89.7\u201398.0) and doxycycline\u2013moxifloxacin was 92.0% (95% CI, 88.1\u201394.6). De novo macrolide resistance was detected in 4.6% of cases. Combining doxycycline\u2013azithromycin data with our prior RGT study (n = 186) yielded a pooled cure of 95.7% (95% CI, 91.6\u201397.8). ParC mutations were present in 22% of macrolide-resistant cases.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>These findings support the inclusion of moxifloxacin in resistance-guided strategies and extend the evidence for 2.5 g azithromycin and presumptive use of doxycycline. These data provide an evidence base for current UK, Australian, and European guidelines for the treatment of MG.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/cid\/ciz1031","type":"journal-article","created":{"date-parts":[[2019,10,16]],"date-time":"2019-10-16T22:17:38Z","timestamp":1571264258000},"page":"1461-1468","source":"Crossref","is-referenced-by-count":106,"title":["Resistance-Guided Antimicrobial Therapy Using Doxycycline\u2013Moxifloxacin and Doxycycline\u20132.5 g Azithromycin for the Treatment of Mycoplasma genitalium Infection: Efficacy and Tolerability"],"prefix":"10.1093","volume":"71","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1396-6301","authenticated-orcid":false,"given":"Duygu","family":"Durukan","sequence":"first","affiliation":[{"name":"Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia"},{"name":"Melbourne Sexual Health Centre, Alfred Health, Carlton, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tim R H","family":"Read","sequence":"additional","affiliation":[{"name":"Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia"},{"name":"Melbourne Sexual Health Centre, Alfred Health, Carlton, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gerald","family":"Murray","sequence":"additional","affiliation":[{"name":"Murdoch Children\u2019s Research Institute, Royal Children\u2019s Hospital, Parkville, Victoria, Australia"},{"name":"Centre for Women\u2019s Infectious Diseases, Royal Women\u2019s Hospital, Melbourne, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle","family":"Doyle","sequence":"additional","affiliation":[{"name":"Melbourne Sexual Health Centre, Alfred Health, Carlton, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric P F","family":"Chow","sequence":"additional","affiliation":[{"name":"Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia"},{"name":"Melbourne Sexual Health Centre, Alfred Health, Carlton, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lenka A","family":"Vodstrcil","sequence":"additional","affiliation":[{"name":"Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia"},{"name":"Melbourne Sexual Health Centre, Alfred Health, Carlton, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher K","family":"Fairley","sequence":"additional","affiliation":[{"name":"Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia"},{"name":"Melbourne Sexual Health Centre, Alfred Health, Carlton, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ivette","family":"Aguirre","sequence":"additional","affiliation":[{"name":"Melbourne Sexual Health Centre, Alfred Health, Carlton, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisa","family":"Mokany","sequence":"additional","affiliation":[{"name":"SpeeDx Pty Ltd, National Innovation Centre, Eveleigh, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lit Y","family":"Tan","sequence":"additional","affiliation":[{"name":"SpeeDx Pty Ltd, National Innovation Centre, Eveleigh, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcus Y","family":"Chen","sequence":"additional","affiliation":[{"name":"Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia"},{"name":"Melbourne Sexual Health Centre, Alfred Health, Carlton, Victoria, 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