Treating gonorrhoea and Mycoplasma genitalium in the era of azithromycin-resistance

A report on Dr Tim Read’s presentation on Day 2 of the Conference.

It has been a very interesting 2 days at the conference, lots of new information and perspectives to take in and process. This morning I attended the Theme B session on the ‘Changing face of STI’s’. The session provided interesting dialogue around STI concerns and discussions regarding current trends, how PrEP is or is not affecting STI rates and a presentation of the data related to the syphilis outbreak in regional and remote Australia.

Dr Tim Read’s presentation focussed on azithromycin resistant STI’s, in particular gonorrhoea and Mycoplasma genitalium. He interestingly took a look back at the changing resistant patterns and now unused or modified treatments regimes, really showing the antibiotic resistance concerns for effective gonorrhoea treatment. Tim notes there is less confidence now in azithromycin for gonorrhoea and the Australian treatment guidelines are likely to be changed in the near future. Unlike the UK, where there are high levels of azithromycin resistance, Australian treatment guidelines will only require a slight modification at this time, particularly for oropharyngeal infections, with an increase from 1g to 2g oral azithromycin plus 500mg ceftriaxone IM.

The most important take home messages:

  • Always take a culture when treating gonorrhoea - Ceftriaxone = culture!
  • Never screen asymptomatic patients for Mycoplasma genitalium

Author bio:

I have been working in sexual health and sexual assault nursing since 2010. Most recently, I have been acting in the Clinical Nurse Consultant position at the Canberra Sexual Health Centre.