{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T03:47:18Z","timestamp":1792036038433,"version":"4.4.0"},"reference-count":93,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2022,2,19]],"date-time":"2022-02-19T00:00:00Z","timestamp":1645228800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acad Dermatol Venereol"],"published-print":{"date-parts":[[2022,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:label\/>\n                    <jats:p>\n                      <jats:italic>Mycoplasma genitalium<\/jats:italic>\n                      infection contributes to 10\u201335% of non\u2010chlamydial non\u2010gonococcal urethritis in men. In women,\n                      <jats:italic>M<\/jats:italic>\n                      .\n                      <jats:italic>genitalium<\/jats:italic>\n                      is associated with cervicitis and pelvic inflammatory disease (PID) in 10\u201325%. Transmission of\n                      <jats:italic>M<\/jats:italic>\n                      .\n                      <jats:italic>genitalium<\/jats:italic>\n                      occurs through direct mucosal contact.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical features and diagnostic tests<\/jats:title>\n                    <jats:p>Asymptomatic infections are frequent. In men, urethritis, dysuria and discharge predominate. In women, symptoms include vaginal discharge, dysuria or symptoms of PID \u2013 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Therapy<\/jats:title>\n                    <jats:p>\n                      Therapy for\n                      <jats:italic>M .genitalium<\/jats:italic>\n                      is indicated if\n                      <jats:italic>M<\/jats:italic>\n                      .\n                      <jats:italic>genitalium<\/jats:italic>\n                      is detected.\n                    <\/jats:p>\n                    <jats:p>Doxycycline has a cure rate of 30\u201340%, but resistance is not increasing. Azithromycin has a cure rate of 85\u201395% in macrolide\u2010susceptible infections. An extended course of azithromycin appears to have a higher cure rate, and pre\u2010treatment with doxycycline may decrease organism load and the risk of macrolide resistance selection. Moxifloxacin can be used as second\u2010line therapy but resistance is increasing.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Recommended treatment<\/jats:title>\n                    <jats:sec>\n                      <jats:title>\n                        Uncomplicated\n                        <jats:italic>M. genitalium<\/jats:italic>\n                        infection without macrolide resistance mutations or resistance testing:\n                      <\/jats:title>\n                      <jats:p>Azithromycin 500\u2009mg on day one, then 250\u2009mg on days 2\u20135 (oral).<\/jats:p>\n                    <\/jats:sec>\n                    <jats:sec>\n                      <jats:title>\n                        Second\u2010line treatment and treatment for uncomplicated macrolide\u2010resistant\n                        <jats:italic>M. genitalium<\/jats:italic>\n                        infection:\n                      <\/jats:title>\n                      <jats:p>Moxifloxacin 400\u2009mg od for 7\u2009days (oral).<\/jats:p>\n                    <\/jats:sec>\n                    <jats:sec>\n                      <jats:title>\n                        Third\u2010line treatment for persistent\n                        <jats:italic>M. genitalium<\/jats:italic>\n                        infection after azithromycin and moxifloxacin:\n                      <\/jats:title>\n                      <jats:p>Doxycycline or minocycline 100\u2009mg bid for 14\u2009days (oral) may cure 40\u201370%.<\/jats:p>\n                      <jats:p>Pristinamycin 1\u2009g qid for 10\u2009days (oral) has a cure rate of around 75%.<\/jats:p>\n                    <\/jats:sec>\n                    <jats:sec>\n                      <jats:title>\n                        Complicated\n                        <jats:italic>M. genitalium<\/jats:italic>\n                        infection (PID, epididymitis):\n                      <\/jats:title>\n                      <jats:p>Moxifloxacin 400\u2009mg od for 14\u2009days.<\/jats:p>\n                    <\/jats:sec>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>\n                      Main changes from the 2016 European\n                      <jats:italic>M. genitalium<\/jats:italic>\n                      guideline\n                    <\/jats:title>\n                    <jats:p>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\u2010guided therapy is emphasised.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jdv.17972","type":"journal-article","created":{"date-parts":[[2022,2,19]],"date-time":"2022-02-19T05:18:55Z","timestamp":1645247935000},"page":"641-650","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":236,"title":["2021 European guideline on the management of\n                    <i>Mycoplasma genitalium<\/i>\n                    infections"],"prefix":"10.1111","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7464-7435","authenticated-orcid":false,"given":"J.S.","family":"Jensen","sequence":"first","affiliation":[{"name":"Microbiology and Infection Control Statens Serum Institut Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Cusini","sequence":"additional","affiliation":[{"name":"Fondazione IRCCS Ca' Granda Ospedale Maggiore 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