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Mycoplasma genitalium is a frequent cause of urethritis in men and cervicitis and pelvic inflammatory disease in women; it is also associated with preterm delivery. Azithromycin was the preferred first-line therapy before antibiotic resistance patterns prompted a shift. Current CDC guidelines recommend doxycycline followed by azithromycin if macrolide susceptibility is confirmed, or doxycycline followed by moxifloxacin if resistance is present or cannot be tested.
Now, in an open-label trial without resistance testing, researchers in Italy randomized 358 patients with PCR-detected M. genitalium to receive either moxifloxacin (400 mg daily for 10 days) or azithromycin (500 mg daily for 6 days). Almost all participants were men; 20% had…