{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T04:26:22Z","timestamp":1788409582752,"version":"build-2803163510"},"reference-count":11,"publisher":"SAGE Publications","issue":"11-12","license":[{"start":{"date-parts":[[2025,6,24]],"date-time":"2025-06-24T00:00:00Z","timestamp":1750723200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Int J STD AIDS"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>\n                      Azithromycin is first-line for uncomplicated\n                      <jats:italic>Mycoplasma genitalium<\/jats:italic>\n                      (Mgen) treatment in UK and European guidelines, however the rates of azithromycin resistance have increased significantly in recent years leading to higher rates of treatment failure. This study aims to review the disease epidemiology to guide service improvement.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We undertook a retrospective case note review of 1036 persons treated for Mgen over 1067 Mgen-related attendances. We obtained data on demographics, site(s) of infection, antibiotic resistance, treatment regimen received and results of test of cure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      71.1% (\n                      <jats:italic>n<\/jats:italic>\n                      = 759) patients received the recommended first-line regimen of doxycycline and azithromycin. Moxifloxacin is the recommended first-line management for macrolide-resistant or complicated infection. 15% (\n                      <jats:italic>n<\/jats:italic>\n                      = 155) patients received moxifloxacin alone as first-line treatment, and 6.9% (\n                      <jats:italic>n<\/jats:italic>\n                      = 72) patients received doxycycline and moxifloxacin dual therapy. 72.9% (\n                      <jats:italic>n<\/jats:italic>\n                      = 753) samples were successfully tested for macrolide resistance. Of these, 55.5% (\n                      <jats:italic>n<\/jats:italic>\n                      = 418) showed macrolide resistance. 20.6% (\n                      <jats:italic>n<\/jats:italic>\n                      = 7) showed fluoroquinolone resistance.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Resistance data show a macrolide resistance rate of 55.5% across our region, and at least 1 in 10 persons were inappropriately screened for Mgen. We propose a multi-pronged approach which includes strict adherence to testing criteria, local resistance testing, resistance-guided management as well as innovative approaches to improve test of cure rates.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/09564624251353583","type":"journal-article","created":{"date-parts":[[2025,6,24]],"date-time":"2025-06-24T18:55:51Z","timestamp":1750791351000},"page":"902-906","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["<i>Mycoplasma genitalium<\/i>\n                    treatment strategies in the era of significant macrolide resistance: Findings from a multi-centre audit in Northwest England"],"prefix":"10.1177","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-0076-096X","authenticated-orcid":false,"given":"Izuchukwu","family":"Ezeh","sequence":"first","affiliation":[{"name":"The Northern Integrated Contraception, Sexual Health and HIV Service, Manchester University NHS Foundation Trust, Manchester, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bethany","family":"Harrison","sequence":"additional","affiliation":[{"name":"Axess Sexual Health, Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eva","family":"Klesnik-Edwards","sequence":"additional","affiliation":[{"name":"The Northern Integrated Contraception, Sexual Health and HIV Service, Manchester University NHS Foundation Trust, Manchester, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alisha","family":"Varia","sequence":"additional","affiliation":[{"name":"Axess Sexual Health, Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9340-1417","authenticated-orcid":false,"given":"Emily","family":"Clarke","sequence":"additional","affiliation":[{"name":"Axess Sexual Health, Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincent","family":"Lee","sequence":"additional","affiliation":[{"name":"The Northern Integrated Contraception, Sexual Health and HIV Service, Manchester University NHS Foundation Trust, Manchester, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,6,24]]},"reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1177\/0956462419825948"},{"key":"e_1_3_4_3_2","volume-title":"Mycoplasma genitalium antimicrobial resistance surveillance (MARS) report: 2023","author":"UK Health Security Agency","year":"2024","unstructured":"UK Health Security Agency. Mycoplasma genitalium antimicrobial resistance surveillance (MARS) report: 2023. London: UK Health Security Agency, 2024. https:\/\/www.gov.uk\/government\/publications\/mycoplasma-genitalium-antimicrobial-resistance-surveillance-mars\/mycoplasma-genitalium-antimicrobial-resistance-surveillance-mars-report-2023"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1111\/jdv.17972"},{"key":"e_1_3_4_5_2","volume-title":"Sexually transmitted infections treatment guidelines, 2021: mycoplasma genitalium","author":"Centers for Disease Control and Prevention","year":"2021","unstructured":"Centers for Disease Control and Prevention. Sexually transmitted infections treatment guidelines, 2021: mycoplasma genitalium. Atlanta, GA: Centers for Disease Control and Prevention, 2021. https:\/\/www.cdc.gov\/std\/treatment-guidelines\/mycoplasmagenitalium.htm"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1177\/0956462421999287"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.3402\/ijch.v71i0.18203"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-024-63056-1"},{"key":"e_1_3_4_9_2","doi-asserted-by":"publisher","DOI":"10.1177\/0956462420987764"},{"key":"e_1_3_4_10_2","doi-asserted-by":"crossref","unstructured":"Soni S Fifer H Al-Shakarachi Y et al. British association of sexual health and HIV national guideline for the management of infection with Mycoplasma genitalium (in draft). 2024. https:\/\/www.bashh.org\/_userfiles\/pages\/files\/ba02_guideline_mgen_public_cons_version_jan_2025.pdf","DOI":"10.1177\/09564624251359054"},{"key":"e_1_3_4_11_2","volume-title":"Management of mycoplasma genitalium (Mgen) BASHH national clincial audit 2022","author":"British Association for Sexual Health and HIV (2022)","year":"2022","unstructured":"British Association for Sexual Health and HIV (2022). Management of mycoplasma genitalium (Mgen) BASHH national clincial audit 2022. Lichfield: British Association for Sexual Health and HIV, 2022. https:\/\/www.bashh.org\/_userfiles\/pages\/files\/mgen2022version2.pptx"},{"key":"e_1_3_4_12_2","unstructured":"Medicines and Healthcare Products Regulatory Agency (2019). Fluoroquinolone antibiotics: new restrictions and precautions for use due to very rare reports of disabling and potentially long-lasting or irreversible side effects. GOV.UK. Available at: https:\/\/www.gov.uk\/drug-safety-update\/fluoroquinolone-antibiotics-new-restrictions-and-precautions-for-use-due-to-very-rare-reports-of-disabling-and-potentially-long-lasting-or-irreversible-side-effects (Accessed: 28 March 2025)."}],"container-title":["International Journal of STD &amp; AIDS"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/09564624251353583","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/09564624251353583","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/09564624251353583","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T22:46:49Z","timestamp":1777675609000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/09564624251353583"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6,24]]},"references-count":11,"journal-issue":{"issue":"11-12","published-print":{"date-parts":[[2025,10]]}},"alternative-id":["10.1177\/09564624251353583"],"URL":"https:\/\/doi.org\/10.1177\/09564624251353583","relation":{},"ISSN":["0956-4624","1758-1052"],"issn-type":[{"value":"0956-4624","type":"print"},{"value":"1758-1052","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,6,24]]}}}