Azithromycin + Doxycycline

The mycoplasma-ureaplasma treatment pack is a combined treatment of two antibiotics: azithromycin and doxycycline, which both work to fight off two different bacterial infections, mycoplasma genitalium (Mgen) and ureaplasma urealycitum (UU).

Mgen and UU are bacteria which can cause infections in your urethral and reproductive tracts. They can often be present without giving you any symptoms, which means that you can have the infections for a while without noticing anything. They’re sexually transmitted infections, which means that they can be passed on through vaginal, oral and anal sex – although they’re most commonly passed on through vaginal sex.

How does mycoplasma-ureaplasma treatment work?

It’s not fully known at the moment whether someone carrying the bacteria but who is asymptomatic necessarily needs treatment. However, where the bacteria is present and causing symptoms, or in people where the bacteria could pose a risk (such as in couples trying to conceive) treatment is usually recommended.^[1]

Its two antibiotic active ingredients work to fight off the bacterial infection. The recommendation is that you take a seven-day course of doxycycline followed by a three-day course of azithromycin. They both work in a similar way, by stopping an enzyme from working which the bacteria needs to sustain itself. Once the bacteria is starved of this enzyme, it stops spreading, and your immune system is then able to fight off the infection.

These two antibiotics are known to be effective at treating MGen and UU, but there have been cases of these infections showing resistance to them. BASHH (the British Association for Sexual Health and HIV) recommends a ten-day, 400mg course of Moxifloxacin if the course of doxycycline and azithromycin doesn’t work to clear up the infection.^[2]

Are there different doses of mycoplasma-ureaplasma treatment?

No. Because it’s an antibiotic, the course will be standard between everyone that uses it and has the same infection.

These antibiotics should work to clear up the infection, but due to antibiotic resistance, it’s possible that you might need to use different antibiotics if your infection hasn’t cleared up after you’ve completed the course of treatment. Make sure that you let your clinician know if you still have symptoms after you’ve finished your course of antibiotics. If you have a sexual partner, they should also take this course of antibiotics, even if they don’t have any symptoms.

After you’ve completed your course of treatment, it’s recommended that you wait for three weeks and then take a test again to see if the infection has cleared to make sure that it’s gone. If it’s still present three weeks after treatment, then it’s generally recommended that you change to a different antibiotic treatment.

You should always take your medication exactly as your clinician advises you to. Typically, though you should:

• Take one tablet of doxycycline, twice a day, for seven days;
• On day eight, take two azithromycin tablets as a single dose;
• On days nine and ten, take one azithromycin tablet each day;
• Swallow the tablets whole with water;
• Make sure you complete the course, even if your symptoms go away before you’ve finished it.

It should start working to fight off the infection as soon as you start taking the medication, but you might not notice your symptoms clearing for a few days. You should be free from both your infection and symptoms by the end of your course, but make sure that you let your clinician know if you still have symptoms after completing your antibiotics so that they can go through the next steps with you.

If your symptoms clear before you’ve finished your course of treatment, don’t take this to mean that you’re free from the infection. Some bacteria might still remain, which can then become resistant to the antibiotics if you don’t finish them – so it’s very important that you complete your course of treatment even if you feel better.

If you forget to take a dose of your treatment, make sure you don’t double dose to make up for the missed dose. Just continue your course as normal. You might just need to shift the above schedule back one day so that you can still complete the full course. If you’re not sure of what to do, ask your clinician – they’ll let you know how to continue your course correctly and safely.

If you accidentally take too much of the treatment, you should speak to a doctor for advice.