{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T07:04:01Z","timestamp":1790665441280,"version":"4.1.0"},"reference-count":35,"publisher":"BMJ","issue":"1","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Sex Transm Infect"],"published-print":{"date-parts":[[2018,2]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      There is increasing evidence that azithromycin 1 g is driving the emergence of macrolide resistance in\n                      <jats:italic>Mycoplasma genitalium<\/jats:italic>\n                      worldwide. We undertook a meta-analysis of\n                      <jats:italic>M. genitalium<\/jats:italic>\n                      treatment studies using azithromycin 1 g single dose and azithromycin 500 mg on day 1 then 250 mg daily for 4 days (5-day regimen) to determine rates of treatment failure and resistance in both regimens.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      The online databases PubMed and Medline were searched using terms \u201c\n                      <jats:italic>Mycoplasma genitalium<\/jats:italic>\n                      \u201d, \u201c\n                      <jats:italic>macrolide\u201d<\/jats:italic>\n                      or \u201c\n                      <jats:italic>azithromycin\u201d<\/jats:italic>\n                      and \u201c\n                      <jats:italic>resistance\u201d<\/jats:italic>\n                      up to April 2016. Studies were eligible if they: used azithromycin 1 g or 5 days, assessed patients for macrolide resistant genetic mutations prior to treatment and patients who failed were again resistance genotyped. Random effects meta-analysis was used to estimate failure and resistance rates.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Eight studies were identified totalling 435 patients of whom 82 (18.9%) had received the 5-day regimen. The random effects pooled rate of treatment failure and development of macrolide antimicrobial resistance mutations with azithromycin 1 g was 13.9% (95% CI 7.7% to 20.1%) and 12.0% (7.1% to 16.9%), respectively. Of individuals treated with the 5-day regimen, with no prior doxycycline treatment, fewer (3.7%; 95% CI 0.8% to 10.3%, p=0.012) failed treatment, all of whom developed resistance (p=0.027).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      Azithromycin 1 g is associated with high rates of treatment failure and development of macrolide resistance in\n                      <jats:italic>M. genitalium<\/jats:italic>\n                      infection with no pre-existing macrolide mutations. There is moderate but conflicting evidence that the 5-day regimen may be more effective and less likely to cause resistance.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/sextrans-2016-053060","type":"journal-article","created":{"date-parts":[[2017,7,17]],"date-time":"2017-07-17T20:50:20Z","timestamp":1500324620000},"page":"14-20","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":64,"title":["Which azithromycin regimen should be used for treating\n                    <i>Mycoplasma genitalium<\/i>\n                    ? 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