Background: Mycoplasma genitalium (MG) is the causative organism in 20-40% of recurrent/persistent non-gonococcal urethritis (NGU) cases in Europe. The 2009 European NGU guideline recommends the use of moxifloxacin in the event of first line treatment failure. Despite its high efficacy in MG eradication, this drug has undesirable side effects and is costly. Thus, many sexual health clinics choose to avoid the unnecessary use of moxifloxacin by testing for MG. However, this requires specialist labroatory input and is also expensive. This study aims to determine whether mycoplasma testing is cost effective and a clinically relevant tool for NGU patients that are subject to the second line treatment regimens.
Methods: The patient records and laboratory results of all patients who received Mycoplasma testing for treatment resistant NGU at a UK level 3 sexual health clinic were reviewed.
Results: Pilot results indicate that very few tests for MG were requested of which none were positive. In those patients moxifloxacin treatment was avoided. However, a number of patients and their partners were treated with moxifloxacin without being tested for MG which makes cost-effectiveness assessment difficult. A full data set will be available by the conference.
Conclusions: MG testing can avoid unnecessary treatment with moxifloxacin for recurrent/persistent NGU, thus avoiding potentially serious cardiac side effects and the expense of the drug. Clinics should develop treatment and investigation pathways for recurrent/persistent NGU to ensure best use of resources and to avoid unnecessary treatment with moxifloxacin.