Brett Hadlow
Clinical posts from members and guests of the Australasian Society for HIV, Viral Hepatitis and Sexual Health Medicine (ASHM) from various international medical and scientific conferences on HIV, AIDS, viral hepatitis, and sexual health.
Evolution and global spread of resistance in Mycoplasma genitalium
Today I watched Catriona Bradshaw (Monash University, Melbourne) present on M.G.
WOW. Great presentation.
M.G Slow to grow and difficult to culture.
Looking at resistance patterns around the world its very clear that over prescribing of Azithromycin has lead to macrolide resistance in M.G.
Looking at countries that have prescribed STAT Azithromycin for NGU and now looking at resistance profiles its very evident that we need to change our thinking and prescribing.
Catriona showed the resistance profiles of two countries side by side - Sweden and Norway. One Country having used Azithromycin in NGU treatment and the other having used Doxycyclin. Very different results.
It made me think of the landscape in Australia - and the different drugs being used in current guidelines. Which I might add are always evolving with new evidence.
Russia has a low prevalence of resistance - Its not used Azithromycin.
Countries that have used Azithromycin in NGU have had an increase in resistance from 10% to 40% in 10 years.
Widespread use of Azithromycin for STIs and Syndromes has led to high failure rates for M.G.
Some regions already leading the way - U.K. And Europe changing guidelines to recommend Doxycyclin.
We need to move towards testing that can perform resistance testing so treatment can be individualised. This will shorten the duration of infection, reduce transmission of resistant strains and recurrent clinical presentations.