{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T17:56:56Z","timestamp":1776880616040,"version":"3.51.2"},"reference-count":7,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Sex Transm Infect"],"accepted":{"date-parts":[[2026,3,29]]},"abstract":"\n Objective<\/jats:title>\n \n To evaluate the efficacy of pristinamycin in treating\n Mycoplasma genitalium<\/jats:italic>\n infection among patients who experienced failure of resistance-guided treatment regimens.\n <\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n This observational study reviewed pharmaceutical and clinical records of patients who received pristinamycin via the named-patient mechanism at a London sexual health service between October 2019 and February 2025. Eligible participants had documented clinical and\/or microbiological failure following resistance-guided therapy. Data collected included demographics, sexuality, infection site, macrolide resistance results, prior antibiotic exposure and tetracycline pretreatment. The primary outcome was microbiological cure, defined as a negative test-of-cure \u22654 weeks post treatment. The secondary outcome was clinical cure, defined as resolution of symptoms in the absence of a confirmatory test. We compared proportions with Fisher\u2019s exact test for 2\u00d72 comparisons and a single global \u03c7\n 2<\/jats:sup>\n test for multicategory comparisons, reporting relative risks with 95% CIs.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Sixty-eight patients were identified; 87% were male, 57% were men who have sex with men, and the mean age was 37 years. Nearly all (97%) had macrolide-resistant infections. Most (81%) had previously received moxifloxacin and the median number of prior antimicrobial courses was three. Microbiological cure was achieved in 71% (48\/68; 95%\u2009CI 58% to 81%)\u2009and clinical cure in 76% (52\/68; 95%\u2009CI 65% to 86%). When stratified by the use or non-use of tetracycline pretreatment and by the indication for the test, no statistically significant difference in either microbiological or clinical cure was observed.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n Pristinamycin achieved microbiological and clinical cure rates of 71\u201376% in patients with macrolide-resistant\n M. genitalium<\/jats:italic>\n infection. These findings align with previously published observational data, supporting pristinamycin as an effective and tolerable third-line treatment option following macrolide-based and quinolone-based regimen failure. Development of standardised algorithms is warranted to optimise management of resistant\n M. genitalium<\/jats:italic>\n infection.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1136\/sextrans-2025-056840","type":"journal-article","created":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T17:20:39Z","timestamp":1776878439000},"page":"sextrans-2025-056840","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Efficacy of pristinamycin in the treatment of people with\n Mycoplasma genitalium<\/i>\n infection experiencing resistance-guided treatment failure: an observational study"],"prefix":"10.1136","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-2152-4881","authenticated-orcid":false,"given":"Gabrielle","family":"Geddes","sequence":"first","affiliation":[{"name":"School of Medicine, University of Glasgow, Glasgow, Scotland, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elisha","family":"Peter","sequence":"additional","affiliation":[{"name":"Chelsea and Westminster Hospital NHS Foundation Trust, London, England, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Heidi","family":"Saweres","sequence":"additional","affiliation":[{"name":"Chelsea and Westminster Hospital NHS Foundation Trust, London, England, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jasmini","family":"Alagaratnam","sequence":"additional","affiliation":[{"name":"Chelsea and Westminster Hospital NHS Foundation Trust, London, England, UK"},{"name":"Imperial College London, London, England, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3070-1281","authenticated-orcid":false,"given":"Gary","family":"Whitlock","sequence":"additional","affiliation":[{"name":"Chelsea and Westminster Hospital NHS Foundation Trust, London, England, UK"},{"name":"Imperial College London, London, England, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8507-6597","authenticated-orcid":false,"given":"Rachael","family":"Jones","sequence":"additional","affiliation":[{"name":"Chelsea and Westminster Hospital NHS Foundation Trust, London, England, UK"},{"name":"Imperial College London, London, England, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2434-0101","authenticated-orcid":false,"given":"Michael","family":"Rayment","sequence":"additional","affiliation":[{"name":"Chelsea and Westminster Hospital NHS Foundation Trust, London, England, UK"},{"name":"Imperial College London, London, England, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2026,4,22]]},"reference":[{"key":"2026042210203050000_sextrans-2025-056840v1.1","doi-asserted-by":"crossref","first-page":"9564624251359054","DOI":"10.1177\/09564624251359054","article-title":"British Association of Sexual Health and HIV National guideline for the management of infection with Mycoplasma genitalium, 2025","volume":"17","author":"Soni","year":"2025","journal-title":"Int J STD AIDS"},{"key":"2026042210203050000_sextrans-2025-056840v1.2","doi-asserted-by":"crossref","DOI":"10.1186\/s12879-015-1041-6","article-title":"Management of Mycoplasma genitalium infections - can we hit a moving target?","volume":"15","author":"Jensen","year":"2015","journal-title":"BMC Infect Dis"},{"key":"2026042210203050000_sextrans-2025-056840v1.3","doi-asserted-by":"crossref","first-page":"101047","DOI":"10.1016\/j.lanmic.2024.101047","article-title":"Evolving patterns of macrolide and fluoroquinolone resistance in Mycoplasma genitalium: an updated systematic review and meta-analysis","volume":"6","author":"Chua","year":"2025","journal-title":"Lancet Microbe"},{"key":"2026042210203050000_sextrans-2025-056840v1.4","unstructured":"UKHSA . Mycoplasma genitalium antimicrobial resistance surveillance (MARS) report: 2023. Mycoplasma genitalium antimicrobial resistance surveillance (MARS) - GOV.UK; 2025."},{"key":"2026042210203050000_sextrans-2025-056840v1.5","doi-asserted-by":"publisher","DOI":"10.3201\/eid2402.170902"},{"key":"2026042210203050000_sextrans-2025-056840v1.6","doi-asserted-by":"publisher","DOI":"10.1136\/sextrans-2023-056093"},{"key":"2026042210203050000_sextrans-2025-056840v1.7","doi-asserted-by":"publisher","DOI":"10.1136\/sextrans-2025-056517"}],"container-title":["Sexually Transmitted Infections"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/sextrans-2025-056840","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T17:20:41Z","timestamp":1776878441000},"score":1,"resource":{"primary":{"URL":"https:\/\/sti.bmj.com\/lookup\/doi\/10.1136\/sextrans-2025-056840"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,22]]},"references-count":7,"alternative-id":["10.1136\/sextrans-2025-056840"],"URL":"https:\/\/doi.org\/10.1136\/sextrans-2025-056840","relation":{},"ISSN":["1368-4973","1472-3263"],"issn-type":[{"value":"1368-4973","type":"print"},{"value":"1472-3263","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,22]]}}}