Mgen causes NGU and is believed to cause PID. High rates of macrolide resistance are well documented globally for Mgen. In Brighton, patients with NGU and PID are tested for Mgen and TOC) offered post-treatment.
114 patients with Mgen participated in the study. 18% of men with NGU and 9% of women with PID had Mgen. 62/114 returned for the first test TOC 4 weeks after treatment. 27/62 had a positive TOC; 25/27 had received azithromycin first line, 1/27 had received moxifloxacin first line and 1/27 had received doxycycline first line. 20/27 returned for a second TOC 4 weeks later. 5/20 patients were positive on the second TOC; 3/5 had received azithromycin second line and 2/5 had received moxifloxacin second line. Patients were more likely to have a positive TOC if they were at risk of reinfection.
The study concluded through its findings that treatment failure rates for Mgen following azithromycin use are substantial, raising concerns regarding resistance. However, reinfection risk may contribute, suggesting a requirement for improved public awareness and clinician knowledge.
Reference: https://srh.bmj.com/content/46/2/132
