背景:生殖支原体是一种新兴的病原体,这与宫颈炎有关,尿道炎和盆腔炎(PID)。随着用于性传播感染的多重聚合酶链反应(PCR)小组的出现,它越来越多地在孕妇中被发现。
目的:目的是审查国际指南,对妊娠和哺乳期生殖支原体感染的治疗有明确的建议。
方法:PubMed,EMBASE和Cochrane数据库进行了无年龄审查,物种,语言或日期限制。
方法:如果研究明确推荐在妊娠期治疗生殖支原体,则纳入研究。如果没有怀孕的建议,研究被排除在外,如果他们提到了其他国际指南建议或指南的历史版本。
方法:手动审查参考文献,选择50篇论文进行审查。最终分析中只包含了四个指南,它们来自欧洲,英国,澳大利亚和Aotearoa新西兰。
结果:所有研究都推荐阿奇霉素作为一线治疗,并建议不要使用莫西沙星。阿奇霉素的给药方案,不同的指导方针,以及对大环内酯耐药感染的普立霉素的效用/安全性。阿奇霉素的安全性数据通常令人放心,但普里斯霉素的安全性数据不一致。
结论:阿奇霉素是大环内酯敏感或未知耐药性感染的一线治疗药物,但是在妊娠/哺乳期大环内酯耐药感染中,阿奇霉素的给药或普利霉素的实用性/安全性缺乏一致性。
BACKGROUND: Mycoplasma genitalium is an emerging pathogen, which has been linked to cervicitis, urethritis and pelvic inflammatory disease (PID). With the advent of multiplex polymerase chain reaction (PCR) panels for sexually transmitted infections, it is increasingly being identified in pregnant women.
OBJECTIVE: The aim was to review international
guidelines, which had explicit recommendations for treatment of M. genitalium infection in pregnancy and breastfeeding.
METHODS: PubMed, EMBASE and Cochrane databases were reviewed with no age, species, language or date restrictions.
METHODS: Studies were included if they had an explicit recommendation for treatment of M. genitalium in pregnancy. Studies were excluded if there was no recommendation in pregnancy, if they referred to other international
guideline recommendations or were historical versions of
guidelines.
METHODS: References were manually reviewed and 50 papers were selected for review. Only four
guidelines were included in the final analysis and they were from Europe, UK, Australia and Aotearoa New Zealand.
RESULTS: All studies recommended azithromycin as first-line treatment, and advised against moxifloxacin use. The dosing schedule of azithromycin, varied between
guidelines, as did the utility/safety of pristinamycin for macrolide resistant infections. Safety data was generally reassuring for azithromycin but inconsistent for pristinamycin.
CONCLUSIONS: Azithromycin is the first-line treatment for macrolide susceptible or unknown resistance infections, but there is a lack of consistency regarding dosing of azithromycin or the utility/safety of pristinamycin for macrolide resistant infections in pregnancy/lactation.