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Use of Pristinamycin for Macrolide-Resistant Mycoplasma genitalium Infection

机译:普瑞司汀霉素用于抵抗大环内酯类生殖器支原体感染

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High levels of macrolide resistance and increasing fluoroquinolone resistance are found in Mycoplasma genitalium in many countries. We evaluated pristinamycin for macrolide-resistant M. genitalium in a sexual health center in Australia. Microbiologic cure was determined by M. genitalium– specific 16S PCR 14–90 days after treatment began. Of 114 persons treated with pristinamycin, infection was cured in 85 (75%). This percentage did not change when pristinamycin was given at daily doses of 2 g or 4 g or at 3 g combined with 200 mg doxycycline. In infections with higher pretreatment bacterial load, treatment was twice as likely to fail for each 1 log 10 increase in bacterial load. Gastrointestinal side effects occurred in 7% of patients. Pristinamycin at maximum oral dose, or combined with doxycycline, cured 75% of macrolide-resistant M. genitalium infections. Pristinamycin is well-tolerated and remains an option where fluoroquinolones have failed or cannot be used.
机译:在许多国家的生殖器支原体中发现了高水平的大环内酯抗药性和增加的氟喹诺酮抗药性。我们在澳大利亚的一家性健康中心评估了普ristinamycin对大环内酯类耐药的生殖器支原体的存在。在治疗开始后14-90天,通过生殖器支原体特异性16S PCR确定微生物学治愈。在接受朴霉素治疗的114例患者中,有85例(75%)感染得到治愈。当每日剂量为2 g或4 g或3 g与200 mg多西环素联用时,给予倍他霉素的比例不会改变。在具有较高的预处理细菌负荷的感染中,细菌负荷每增加1 log 10,治疗失败的可能性就会增加两倍。 7%的患者发生胃肠道副作用。以最大口服剂量使用普瑞司他霉素或与强力霉素联用可治愈75%的大环内酯耐药性生殖器支原体感染。 Pristinamycin具有良好的耐受性,在氟喹诺酮类药物失效或无法使用时,仍然是一种选择。

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