The U.S. Centers for Disease Control and Prevention recommends a step-wise treatment approach for<unk>  with doxycycline for 7 days followed immediately by a 7 day course of moxifloxacin as the preferred therapy due to high rates of macrolide resistance. If resistance assay testing is available, and the<unk>  is sensitive to macrolides; the CDC recommends a 7 day course of doxycycline followed by a 4 day course of azithromycin. If moxifloxacin is not available; the CDC recommends as an alternative regiment, 7 days of doxycycline followed by the 4 day course of azithromycin, with a test of cure 21 days after treatment being required due to the high rate of macrolide resistance. The CDC notes that beta lactam antibiotic are not effective against<unk>  as the organism lacks a cell wall. Treatment of<unk>  infections is becoming increasingly difficult due to rapidly growing antimicrobial resistance. Diagnosis and treatment is further hampered by the fact that<unk>  infections are not routinely tested. Studies have demonstrated that a 5-day course of azithromycin has a superior cure rate compared to a single, larger dose. Further, a single dose of azithromycin can lead to the bacteria becoming resistant to azithromycin. Among Swedish patients, doxycycline was shown to be relatively ineffective (with a cure rate of 48% for women and 38% for men); and treatment with a single dose of azithromycin is not prescribed due to it inducing antimicrobial resistance. The five-day treatment with azithromycin showed no development of antimicrobial resistance. Based on these findings, UK doctors are moving to the 5-day azithromycin regimen. Doxycycline is also still used, and moxifloxacin is used as a second-line treatment in case doxycyline and azithromycin are not able to eradicate the infection. In patients where doxycycline, azithromycin and moxifloxacin all failed, pristinamycin has been shown to still be able to eradicate the infection.
Mycoplasma genitalium
Trichomonas vaginalis
Chlamydia trachomatis
Trichomonas tenax
Haemophilus ducreyi
Treponema pallidum
Mycobacterium ulcerans
Trichobacteriosis axillaris