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Mycoplasma genitalium — SCE Infectious Diseases MCQ

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HardSTIsMycoplasma genitaliumSCE Infectious Diseases

A 23-year-old man presents with urethral discharge. NAAT is positive for Mycoplasma genitalium. He has previously been treated with Azithromycin 1 g single dose with no resolution. Macrolide resistance-associated mutation testing shows 23S rRNA mutation present. What is the most appropriate treatment?

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Correct answer: B — Moxifloxacin 400 mg daily for 7 days

Macrolide-resistant M. genitalium (23S rRNA mutation detected) should be treated with Moxifloxacin 400 mg daily for 7 days, which has cure rates >90% for macrolide-resistant strains. BASHH strongly recommends resistance-guided therapy for M. genitalium using macrolide resistance testing before treatment to avoid further resistance selection. If Moxifloxacin also fails, Pristinamycin or Minocycline may be considered as third-line options.

Reference: https://www.nice.org.uk/guidance/conditions-and-diseases/infections