S3E13 - Resistance Guided Mycoplasma Genitalium Treatment

Welcome to Season 3 of AMC Clinical Deep Dive! Driven by alarming macrolide resistance (>60% in Australia), Mycoplasma genitalium (M. gen.) management requires resistance-guided sequential therapy. This episode deconstructs the ASHM guidelines for OSCE success. Learn why routine asymptomatic screening is contraindicated and why Doxycycline (100mg BD for 7 days) must precede targeted treatment—either Azithromycin for susceptible strains or Moxifloxacin for resistant infections. We cover 14-day Moxifloxacin PID protocols, pregnancy safety traps, contact tracing for ongoing partners, and timing the mandatory 14–21 day Test of Cure. #AMCClinicalExam #MycoplasmaGenitalium #OSCE #ResistanceGuidedTherapy #MoxifloxacinProtocol #MacrolideResistance #TestofCure #IMGAustralia #ASHMGuidelines #DoxycyclineSequentialTherapy Pro Tip: In your OSCE, never prescribe single-dose Azithromycin or immediate Moxifloxacin alone! High-scoring candidates demonstrate safety by explicitly using resistance-guided sequential therapy: initiating Doxycycline 100mg BD for 7 days to reduce bacterial load before stepping up to Azithromycin (if susceptible) or Moxifloxacin 400mg daily (if resistant). Highlight key exam traps: routine asymptomatic screening is NOT recommended, Moxifloxacin is Category B3 and avoided in pregnancy (requiring specialist input/Pristinamycin), and a Test of Cure (TOC) by NAAT must be delayed until 14–21 days post-treatment to avoid false positives! 🎧 ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Episodes in ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Season 1⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ (150 clinical scenarios) have been indexed by topic, patient group, discipline, setting, and more to support targeted learning. Use the filters to locate discussions relevant to your study or clinical training.