Use of Pristinamycin for Macrolide-Resistant Mycoplasma genitalium Infection.

Abstract

High levels of macrolide resistance and increasing fluoroquinolone resistance are found in Mycoplasma genitalium in many countries. We evaluated pristinamycin for macrolide-resistant M. genitalium in a sexual health center in Australia. Microbiologic cure was determined by M. genitalium-specific 16S PCR 14-90 days after treatment began. Of 114 persons treated with pristinamycin, infection was cured in 85 (75%). This percentage did not change when pristinamycin was given at daily doses of 2 g or 4 g or at 3 g combined with 200 mg doxycycline. In infections with higher pretreatment bacterial load, treatment was twice as likely to fail for each 1 log10 increase in bacterial load. Gastrointestinal side effects occurred in 7% of patients. Pristinamycin at maximum oral dose, or combined with doxycycline, cured 75% of macrolide-resistant M. genitalium infections. Pristinamycin is well-tolerated and remains an option where fluoroquinolones have failed or cannot be used.

• Authors: Tim R H Read, Jørgen S Jensen, Christopher K Fairley, Mieken Grant, Jennifer A Danielewski, Jenny Su, Gerald L Murray, Eric P F Chow, Karen Worthington, Suzanne M Garland, Sepehr N Tabrizi, Catriona S Bradshaw
• Journal: Emerging infectious diseases (Emerg Infect Dis) Vol. 24 Issue 2 Pg. 328-335 (02 2018) ISSN: 1080-6059 [Electronic] United States
• PMID: 29350154 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Anti-Bacterial Agents
• Macrolides
• Pristinamycin

Topics

• Adult
• Anti-Bacterial Agents (pharmacology)
• Drug Resistance, Multiple, Bacterial
• Female
• Humans
• Macrolides (pharmacology)
• Male
• Mycoplasma Infections (drug therapy, microbiology)
• Mycoplasma genitalium (drug effects, genetics)
• Pristinamycin (therapeutic use)