Doxycycline and Sitafloxacin Combination Therapy for Treating Highly Resistant Mycoplasma genitalium

M ycoplasma genitalium is a sexually transmitted bacterium with marked capacity for developing antimicrobial resistance (1). Macrolides and 4th-generation fluroquinolones, such as moxifloxacin, have been the main agents displaying efficacy against M. genitalium. However, macrolide resistance has increased to >50% in many nations, and quinolone resistance is increasing (2-6). In Australia, 16% of M. genitalium strains are reported to have dual-class resistance (5), and Japan reports dual-class resistance of up to 25% (2), resulting in infections that often cannot be cured with current recommended therapies.