Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy · 2025
Effectiveness of intramuscular spectinomycin in difficult-to-treat Mycoplasma genitalium urethritis in four cases.
СтатьяНаблюдательное исследованиеКлинический случайНазвание и аннотация: Перевод в очереди
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Nagase Yuichiro, Hayakawa Kayoko, Kubo Taketo, Okumura Nobumasa, Saito Sho, Ohmagari Norio
Аннотация
OBJECTIVES: Recently, Mycoplasma genitalium (MG) has been reported to have developed antimicrobial resistance. Sequential or combination therapy with doxycycline and fluoroquinolones has been effective in treating difficult-to-treat MG infections. However, therapeutic options are limited when these treatments fail. Hence, this study aimed to evaluate the effectiveness of spectinomycin, which has only been reported in a single case.
METHODS: This retrospective observational study included patients ≥18 years who were diagnosed with MG infection and received at least one intramuscular injection of spectinomycin between December 2019 and May 2024 at the department of infectious diseases of the National Center for Global Health and Medicine.
RESULTS: Four patients met the inclusion criteria. All patients were men and aged between 29 and 62 years, and had received a 7-day course of spectinomycin treatment. All patients had urethritis due to MG and experienced their first episode of MG infection. Two patients were men who had sex with men, one of whom was HIV-positive. All the patients had a history of multiple antimicrobial treatments. MG resistance gene test results were available in three patients. 23SrRNA and parC but not gyrA mutations were detected in all three patients. Three patients received oral doxycycline with spectinomycin for 7 days. After 7 days of spectinomycin treatment, three of the four patients tested negative for MG and were considered clinically and microbiologically effective. No adverse effects of spectinomycin were observed in any patient.
CONCLUSIONS: A7-day spectinomycin intramuscular injection therapy may a useful option for treating refractory MG urethritis.
METHODS: This retrospective observational study included patients ≥18 years who were diagnosed with MG infection and received at least one intramuscular injection of spectinomycin between December 2019 and May 2024 at the department of infectious diseases of the National Center for Global Health and Medicine.
RESULTS: Four patients met the inclusion criteria. All patients were men and aged between 29 and 62 years, and had received a 7-day course of spectinomycin treatment. All patients had urethritis due to MG and experienced their first episode of MG infection. Two patients were men who had sex with men, one of whom was HIV-positive. All the patients had a history of multiple antimicrobial treatments. MG resistance gene test results were available in three patients. 23SrRNA and parC but not gyrA mutations were detected in all three patients. Three patients received oral doxycycline with spectinomycin for 7 days. After 7 days of spectinomycin treatment, three of the four patients tested negative for MG and were considered clinically and microbiologically effective. No adverse effects of spectinomycin were observed in any patient.
CONCLUSIONS: A7-day spectinomycin intramuscular injection therapy may a useful option for treating refractory MG urethritis.