A Systematic Review and Meta-Analysis of Efficacy and Safety of Azithromycin Versus Moxifloxacin for the Initial Treatment of <i>Mycoplasma genitalium</i> Infection
<i>Mycoplasma genitalium</i> is recognized as a remarkable pathogen since azithromycin-resistant strains and treatment failure have been increasingly reported. Nevertheless, international guidelines still recommend azithromycin as a first-line treatment and moxifloxacin as a second-line...
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MDPI AG
2022-03-01
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| Online Access: | https://www.mdpi.com/2079-6382/11/3/353 |
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| author | Hideo Kato Mao Hagihara Nobuhiro Asai Jun Hirai Yuka Yamagishi Takuya Iwamoto Hiroshige Mikamo |
| author_facet | Hideo Kato Mao Hagihara Nobuhiro Asai Jun Hirai Yuka Yamagishi Takuya Iwamoto Hiroshige Mikamo |
| author_sort | Hideo Kato |
| collection | DOAJ |
| description | <i>Mycoplasma genitalium</i> is recognized as a remarkable pathogen since azithromycin-resistant strains and treatment failure have been increasingly reported. Nevertheless, international guidelines still recommend azithromycin as a first-line treatment and moxifloxacin as a second-line treatment. We performed a systematic review and meta-analysis to validate the efficacy and safety of both drugs in the initial treatment of <i>M. genitalium</i>. We systematically searched the EMBASE, PubMed, Scopus, Ichushi, and CINAHL databases up to December 2021. We defined efficacy as clinical and microbiologic cure, and safety as persistent diarrhea. Overall, four studies met the inclusion criteria: one showed clinical cure (azithromycin treatment, n = 32; moxifloxacin treatment, n = 6), four showed microbiologic cure (n = 516; n = 99), and one showed safety (n = 63; n = 84). Moxifloxacin improved the microbiologic cure rate compared with azithromycin (odds ratio [OR] 2.79, 95% confidence interval [CI], 1.06–7.35). Clinical cure and safety did not show a significant difference between azithromycin and moxifloxacin treatments (OR 4.51, 95% CI 0.23–88.3; OR 0.63, 95% CI 0.21–1.83). Our meta-analysis showed that moxifloxacin was more effective than azithromycin at eradicating <i>M. genitalium</i> infections and supports its preferential use as a first-line treatment. |
| first_indexed | 2024-03-09T20:12:52Z |
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| institution | Directory Open Access Journal |
| issn | 2079-6382 |
| language | English |
| last_indexed | 2024-03-09T20:12:52Z |
| publishDate | 2022-03-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Antibiotics |
| spelling | doaj.art-b4de22993d9a48748c8cd5963bb244022023-11-24T00:11:10ZengMDPI AGAntibiotics2079-63822022-03-0111335310.3390/antibiotics11030353A Systematic Review and Meta-Analysis of Efficacy and Safety of Azithromycin Versus Moxifloxacin for the Initial Treatment of <i>Mycoplasma genitalium</i> InfectionHideo Kato0Mao Hagihara1Nobuhiro Asai2Jun Hirai3Yuka Yamagishi4Takuya Iwamoto5Hiroshige Mikamo6Department of Clinical Infectious Diseases, Aichi Medical University, Nagakute 480-1195, JapanDepartment of Clinical Infectious Diseases, Aichi Medical University, Nagakute 480-1195, JapanDepartment of Clinical Infectious Diseases, Aichi Medical University, Nagakute 480-1195, JapanDepartment of Clinical Infectious Diseases, Aichi Medical University, Nagakute 480-1195, JapanDepartment of Clinical Infectious Diseases, Aichi Medical University, Nagakute 480-1195, JapanDepartment of Pharmacy, Mie University Hospital, Tsu 514-8507, JapanDepartment of Clinical Infectious Diseases, Aichi Medical University, Nagakute 480-1195, Japan<i>Mycoplasma genitalium</i> is recognized as a remarkable pathogen since azithromycin-resistant strains and treatment failure have been increasingly reported. Nevertheless, international guidelines still recommend azithromycin as a first-line treatment and moxifloxacin as a second-line treatment. We performed a systematic review and meta-analysis to validate the efficacy and safety of both drugs in the initial treatment of <i>M. genitalium</i>. We systematically searched the EMBASE, PubMed, Scopus, Ichushi, and CINAHL databases up to December 2021. We defined efficacy as clinical and microbiologic cure, and safety as persistent diarrhea. Overall, four studies met the inclusion criteria: one showed clinical cure (azithromycin treatment, n = 32; moxifloxacin treatment, n = 6), four showed microbiologic cure (n = 516; n = 99), and one showed safety (n = 63; n = 84). Moxifloxacin improved the microbiologic cure rate compared with azithromycin (odds ratio [OR] 2.79, 95% confidence interval [CI], 1.06–7.35). Clinical cure and safety did not show a significant difference between azithromycin and moxifloxacin treatments (OR 4.51, 95% CI 0.23–88.3; OR 0.63, 95% CI 0.21–1.83). Our meta-analysis showed that moxifloxacin was more effective than azithromycin at eradicating <i>M. genitalium</i> infections and supports its preferential use as a first-line treatment.https://www.mdpi.com/2079-6382/11/3/353meta-analysis<i>Mycoplasma genitalium</i>azithromycinmoxifloxacininitial treatment |
| spellingShingle | Hideo Kato Mao Hagihara Nobuhiro Asai Jun Hirai Yuka Yamagishi Takuya Iwamoto Hiroshige Mikamo A Systematic Review and Meta-Analysis of Efficacy and Safety of Azithromycin Versus Moxifloxacin for the Initial Treatment of <i>Mycoplasma genitalium</i> Infection Antibiotics meta-analysis <i>Mycoplasma genitalium</i> azithromycin moxifloxacin initial treatment |
| title | A Systematic Review and Meta-Analysis of Efficacy and Safety of Azithromycin Versus Moxifloxacin for the Initial Treatment of <i>Mycoplasma genitalium</i> Infection |
| title_full | A Systematic Review and Meta-Analysis of Efficacy and Safety of Azithromycin Versus Moxifloxacin for the Initial Treatment of <i>Mycoplasma genitalium</i> Infection |
| title_fullStr | A Systematic Review and Meta-Analysis of Efficacy and Safety of Azithromycin Versus Moxifloxacin for the Initial Treatment of <i>Mycoplasma genitalium</i> Infection |
| title_full_unstemmed | A Systematic Review and Meta-Analysis of Efficacy and Safety of Azithromycin Versus Moxifloxacin for the Initial Treatment of <i>Mycoplasma genitalium</i> Infection |
| title_short | A Systematic Review and Meta-Analysis of Efficacy and Safety of Azithromycin Versus Moxifloxacin for the Initial Treatment of <i>Mycoplasma genitalium</i> Infection |
| title_sort | systematic review and meta analysis of efficacy and safety of azithromycin versus moxifloxacin for the initial treatment of i mycoplasma genitalium i infection |
| topic | meta-analysis <i>Mycoplasma genitalium</i> azithromycin moxifloxacin initial treatment |
| url | https://www.mdpi.com/2079-6382/11/3/353 |
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