How Do I Get Treated for Mycoplasma Genitalium?

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Question: What is the standard mycoplasma genitalium (MG) treatment?

Answer: Mycoplasma genitalium is most often treated as non-gonococcal urethritis (NGU) or bacterial vaginosis (BV)

Direct diagnosis of an infection with the bacterium that causes "MG" is difficult. It takes up to six months to grow in culture. It can be identified in other ways, but those tests are mostly for research. There is no FDA approved test for mycoplasma.

Because of this, MG tends to be a presumptive diagnosis. In other words, doctors assume something is mycoplasma when they've ruled out other options. Specifically, it's generally assumed to be involved in both BV and NGU infection. In fact, the CDC states that 15%–20% of nongonococcal urethritis (NGU) cases are caused by mycoplasma. In addition MG causes around one in three cases of persistent or recurrent urethritis.

The recognition of how common MG is is very new. That's, in part, because the bacteria was only discovered in the 1980s. But every year, doctors and scientists discover that it plays a role in more genital infections. For example, it is also associated with pelvic inflammatory disease. 

Fortunately, MG can be treated with antibiotics. .

The CDC 2015 treatment guidelines suggest the following mycoplasma genitalium treatments

For people with cervicitis and urethritis

1-g single-dose azithromycin. However, there is growing antibiotic resistance to this regimen. In 2015, there was a trial where this dose cured only 40% of infected patients. 

Moxifloxacin (400 mg daily x 7, 10 or 14 days) can be used for people who have failed treatment with azithromycin. However, there have been some reports of treatment failure. 

For people with pelvic inflammatory disease (PID)

Mycoplasma infection may be suspected if initial antibiotic treatment doesn't work for PID. This is because standard PID regimens are not effective against MG. However, there is no standardized treatment option for women with PID where mycoplasma is suspected. 

In short, good treatments for mycoplasma infection still need to be developed. As problems associated with this infection grow, research will too. Hopefully a treatment will be found that doesn't create the same problems with antibiotic resistance that have been seen with gonorrhea. If not, it is likely that new treatments will needed every few years.

Unfortunately, medication resistance is likely to be an ongoing problem in the world of STD treatments


Centers for Disease Control and Prevention. Sexually Transmitted Diseases Treatment Guidelines, 2015. Accessed 1/2/2016 from:

Centers for Disease Control and Prevention. Sexually Transmitted Diseases Treatment Guidelines, 2010. MMWR 2010;59(No. RR-12). Accessed 7/19/2014 from:

Mycoplasma genitalium: Pathogen or Passenger? Medscape Infectious Diseases. 2008 (Accessed 3/16/08)

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