If you are a male, and after a sexual encounter, you have developed symptoms consistent with chlamydia and gonnorhea, and all commonly tested for STD’s are negative, demand that you be tested to mycoplasma genitalium. If you have been through the gambit of doctors, from urologists to infectious disease, and no matter the antibiotic thrown at you, you never get better, demand that you get tested for mycoplasma genitalium.
The lack of knowledge of MG among the doctor community is scary to put it lightly. Even when MG is tested for, it’s done wrong, out of protocol, and false negatives result in these blanket prostatitis diagnoses that never resolve.
To test accurately on men, you need to be off of antibiotics for 3-4 weeks, and then send in your first void urine. Doctors are testing patients while still on antibiotics and testing urine that is not concentrated enough to show a positive on the PCR. To minimize your chance of a false negative, be clear of antibiotics and test first void urine only.
The next major problem that is developing with MG is it is quickly becoming untreatable. Urologists are prescribing 30-45 days of ciprofloxacin and levofloxacin because they think they are treating some benign bacteria that just happens to not culture out. So what do these geniuses do? They blindly prescribe flouroquinlones that do only one thing...make MG resistant to the one antibiotic that still has some success...and that’s Moxifloxacin.
You see, ciprofloxacin, levofloxacin, and Moxifloxacin are all in the same class of antibiotics and bacteria creates resistance to classes of antibiotics, not individual antibiotics. This means, when a proven sub therapeutic antibiotic is given for an infection, but that bacteria is not going to be eradicated by that sub theraputic antibiotic (ie cipro and levo) the end result is an infection that continues BUT the bacteria also makes a mutation that makes it resistant to any other flouroquinlone (ie Moxifloxacin).
This is a terrible outcome because Moxifloxacin is the only antibiotic in the U.S. that cures 80-85% of the cases of MG.
What’s even more tragic, is this basic knowledge is not common knowledge among doctors. There’s no effective treatment for MG once Moxifloxacin fails.
The recipe for a sexual health disaster is here. MG is NOT reportable so the surveillance of how prevalent it truly is isn’t known, but most studies estimate MG to be as common as chlamydia. There are ~2,000,000 cases of chlamydia in the US annually. If MG is that prevalent, this means 300,000-400,000 people are contracting untreatable infections. This number is likely low given the poor testing practices giving false negatives.
The consequences of this infection are serious. Men often develop prostatitis, and other consequences like sexually acquired reactive arthritis, uveitis, and skin psoriasis are just a few of the serious seemingly unrelated consequences of persistent MG infections.
Where is there hope in this hopeless situation?
1) the US FDA finally approved a test. It still misses 1/10 infections but it’s a start. This test is made by Hologic. Demand your doctor order that test. If you can, test through the University of Alabama at Birmingham’s mycoplasma lab. They can do resistance testing right away, and frankly their doctors and lab is the most knowledgeable with this infection.
2) New antibiotics. Omadacycline might work. It’s currently available and is in the tetracycline family. The real hope is with a new class of antibiotics for systemic human use ...it’s called Lefamulin and the initial activity against even drug resistant strains is very good. This antibiotic will be approved or denied in mid/late August of 2019. Pray that this antibiotics gets approved.
3) Old antibiotics, Pristinamycin is a 3rd line antibiotic that is only available in France. It cures 75% of MG cases and can work with resistant strains 50% of the time. There is a related antibiotic called Synercid in the US. It’s a derivative of Pristinamycin, but has a bad track record of toxicity. I believe Synercid would work, but you would need an open minded doctor. A doctor that truly realizes the seriousness of this infection.
After this, there’s nothing. This will go down as the biggest failing of sexual health since HIV. If you are battling this infection, please know you are not alone. Please reach out. There are those of us suffering too and can relate. We need to band together and make our failing health system better, so others don’t have