Ureaplasma is a common bacterium found in the genitourinary tract of men and women. While often harmless, an active infection can lead to health problems. Managing a Ureaplasma infection is important for health and preventing complications. Effective treatment can eradicate the infection and alleviate concerns.
Identifying the Infection
Ureaplasma is a genus of bacteria in the Mycoplasma family, known for their lack of a cell wall and small size. They are unique in their ability to hydrolyze urea, which gives them their name. Though part of the normal human microbiome, an overgrowth or specific species can cause infection.
Identifying a Ureaplasma infection relies on laboratory tests. Common diagnostic methods include nucleic acid amplification tests (NAATs), such as polymerase chain reaction (PCR). These tests detect the bacteria’s genetic material with high sensitivity and specificity.
Samples for NAATs are collected from likely sites of infection. For men, this includes urine or urethral swabs. For women, vaginal or cervical swabs are used. Accurate diagnosis before treatment ensures the appropriate course of action.
Treatment Options
Treating a Ureaplasma infection involves antibiotics. Antibiotic choice and treatment duration depend on the Ureaplasma species and patient factors. Doxycycline is a common prescription, typically 100 mg orally twice daily for 7 to 14 days. It is effective against Ureaplasma.
Azithromycin is another common antibiotic, prescribed as a single 1-gram dose or a multi-day regimen (500 mg on day one, then 250 mg daily for 4 days). Selection between doxycycline and azithromycin depends on physician preference, patient tolerance, and drug interactions. Completing the entire antibiotic course, even if symptoms improve, ensures bacterial eradication and prevents resistance.
If initial treatments are ineffective or resistance is suspected, other antibiotics may be considered. Moxifloxacin, a fluoroquinolone, can be used (400 mg once daily for 7 to 10 days). It is reserved for resistant cases due to side effects and resistance promotion. For pregnant individuals, macrolide antibiotics like erythromycin or azithromycin are preferred, while tetracyclines like doxycycline are avoided due to potential risks.
Treating sexual partners is important for preventing re-infection. Asymptomatic partners can carry the bacteria and re-introduce infection. Simultaneous treatment for both partners breaks the transmission cycle and increases cure likelihood. Both partners must adhere to the prescribed regimen for successful eradication.
Post-Treatment Care and Monitoring
After antibiotic treatment, monitoring therapy success is important. A “test of cure” (TOC) confirms Ureaplasma eradication. This test ensures bacteria are no longer detectable.
TOC timing is important for accurate results. Wait at least three to four weeks after antibiotics before performing the TOC. This allows time for bacterial genetic material to clear, reducing false positives. A negative TOC indicates successful treatment and Ureaplasma absence.
A positive TOC suggests ineffective initial treatment or re-infection. Further evaluation by a healthcare provider is necessary to determine next steps. Beyond testing, good hygiene and safe sexual practices support recovery and prevent future infections.
Addressing Recurrence and Resistant Cases
Ureaplasma infections can persist or recur despite initial treatment. Factors contributing to treatment failure include non-adherence to the antibiotic regimen (not taking medication as directed or completing the full course). Re-infection from an untreated sexual partner is a common recurrence reason, highlighting partner treatment’s importance.
Antibiotic resistance is a significant factor in persistent cases. Some Ureaplasma strains may not respond to common antibiotics, requiring alternative medications. If standard treatment is unsuccessful, healthcare providers may consider different antibiotics or longer therapy. For instance, if doxycycline or azithromycin fail, moxifloxacin may be prescribed.
Moxifloxacin is considered for resistant Ureaplasma cases (400 mg once daily for 7 to 10 days). Combination antibiotic therapy might be considered, though less common for Ureaplasma. Consult a healthcare provider if symptoms persist or recur after initial treatment. They can conduct further tests to identify resistance patterns and guide a more effective strategy.