u/GirlForce1112

AZITHROMYCIN GUIDELINES

A question that gets asked often here is about how to take Azithromycin after doxycycline. First off, usually when we reference how to take it, we are talking about the CDC guidelines for mycoplasma (ureaplasma is in the mycoplasma family). So that’s easy to google.

FOR EASY REFERENCE:
- 2.5g total is the standard

- 12 hours after DOXY: You take 1g (that might be 2 pills, maybe 4. Do the math depending on what dose your pills are!! Often 250mg or 500mg)

- then you take 500mg daily until they are finished (usually 3 days)

https://www.cdc.gov/std/treatment-guidelines/mycoplasmagenitalium.htm

In general, please utilize the resources of this group, especially the info guide if you’re new to this infection. All the pinned posts at the top of this subreddit have a plethora of info.

We didn’t have the azithro guidelines “officially” posted anywhere though so here they are.
The fact that the guidelines often prove unsuccessful and we tend to advocate longer treatments here is a separate issue…

A reminder that we have a zoom support meeting scheduled for 2pm CST today. If you’d like to connect, please RSVP here and I will add you to the chat to receive the link. ✨

“I’VE JUST BEEN DIAGNOSED. NOW WHAT?”

I’m putting this info out there, all in one place, for people who need general guidance on where to start with this infection. Please read throughly!

*Please be aware there really are no standard guidelines for ureaplasma in most countries. You can look up the CDC guidelines in the USA for mycoplasma. Ureaplasma can potentially be treated with the same antibiotics, as they are in the same family*.

The general consensus here, however, is that those guidelines are not sufficient. The advice here is just that. ADVICE. Based on opinions and experience. We are not doctors and nothing here should be considered medical advice. This is why it gets complicated to post a specific protocol.

But here are *my personal opinions* on approaching ureaplasma after an *initial diagnosis* (this advice is not necessarily for chronic suffers and especially those who have failed multiple treatments):

1.) HOW SHOULD I TREAT?
Short courses rarely work.
14 days doxycycline and 2.5g of Azithromycin is often done by people here as an initial treatment. This is slightly longer than the CDC protocol.
I don’t think this has a high success rate.
I tend to recommend 28 days doxy and 7 days Azithromycin as an initial treatment. But if you are worried about extended antibiotics or don’t tolerate antibiotics well, you can try this first.

Please see our post on how to take the standard dose (2.5g) of Azithromycin, if you go that route, because many people find it confusing. You should take a longer course the same way, you’ll just be doing it longer.
https://www.reddit.com/r/ureaplasmasupport/s/Oj2o8B5cxk

Fluoroquinolones such as Moxifloxacin should be reserved for after this treatment has failed, as they come with a risk of severe side effects (please research if you’re considering this class of antibiotic).

2.) SHOULD MY PARTNER ALSO BE TREATED?
A resounding YES. This is an STI. Men are often asymptomatic and test negative. Doesn’t matter. If asymptomatic, the 7-14 days doxy and 2.5g may bend sufficient but we really don’t know for sure and when they are asymptomatic, it’s very hard to know if they are actually cured.
No sex should happen until both partners are symptom free and negative (6-8 weeks post treatment).

3.) WHY MIGHT WE NEED ANTIBIOTICS FOR SO LONG?
You do not want to PARTIALLY treat this bacteria. It’s a tricky, teeny-tiny little intracellular bacteria and it will make it difficult for you.
This is the biggest problem we see here. Doctors prescribe ridiculously short courses and people end up with symptoms that haven’t fully resolved or go away and then return days or weeks later.
IF YOU ARE SEEING IMPRPROVEMENT on your antibiotics and are not completely symptom free towards the end of your course, PLEASE ask your doctor to extend it!
Way too many people here stop before they are done! This is a recipe for a resistant infection embedded in biofilm. Not. Good.

There is a reason doctors and all antibiotic inserts instruct people to continue their course until the end even if symptoms are gone. Why?? Because there can be low levels of bacteria still there once your symptoms go away. You have to continue the medication further in order to eradicate it.

So if you are not even symptom free on antibiotics, you’re DEFINITELY not done! (This is assuming you are seeing noticeable improvement. If you are NOT noticing improvement within 2 weeks, you may need an alternative antibiotic. Please be aware that everyone is different in when they tend to respond to treatment.)

4.) I’VE HEARD LINGERING SYMPTOMS ARE NORMAL AFTER ANTIBIOTICS
The philosophy of this group is that lingering symptoms mean something is still going on. The philosophy of this group is that testing is not accurate after treatment. Trust your symptoms.

5.) WHEN DO I RE-TEST?
You want to attempt avoid a false negative, which is extremely common. I wouldn’t trust anything prior to 6-8 weeks post antibiotics. I’d trust a negative even less at that point if I still had symptoms.
DONT SIT AROUND IN PAIN. If you are still experiencing symptoms, go ahead and test for all other possible infection 7-14 days post treatment.
If they are negative or if treating what shows up doesn’t help, I’d assume it’s still ureaplasma and try to get back on treatment asap.

6.) I DONT HAVE SYMPTOMS, DO I HAVE TO TREAT?
Reasons to treat if you are asymptomatic:

- you’re trying to get pregnant or would like to in the future. Ureaplasma can cause infertility, miscarriage, and pre-term birth in some cases.

- you’re not in a committed relationship with one person (who is ALSO asymptomatic). Even if you’re asymptomatic, you can pass it to other sexual partners, who may not be so lucky. If your partner has symptoms but you do not, you’d want to treat to avoid reinfecting them.

- you have reoccurring BV or yeast. Or you have been experiencing infertility. These ARE symptoms of ureaplasma.

7.) MY DOCTOR WONT TEST FOR THIS OR REFUSES TO TREAT IT APPROPRIATELY
Most doctors still do not acknowledge that ureaplasma can be pathogenic. This is common, regardless of what country you’re in. I am in the USA however so my advice on this may not apply to everyone here, unfortunately. There are a few ways to approach this:

For treatment-

- Use an online pharmacy. TelyRx is recommended here a lot. They have good, sufficient quantities of doxycycline (and minocycline). But there are many others. Google.

- Put serious effort into finding a doctor who will at least be open minded and listen to you.

- Seek out a chronic specialist. They aren’t perfect but pickings are slim. They are more likely to treat with extended or long term antibiotics and not brush off your symptoms. Here are the ones I know of:

- Dr Stewart Bundrick (UTI only, no vaginal issues, offers virtual appointments after initial visit)
- Dr Ryan Heer (fully virtual)
- NY urology
- Artemis Clinic at Harley Street (UK but has virtual options, primarily a UTI clinic)

For testing -
There are many at-home microbiome tests you can order. Microgendx, Juno, Evvy, Daye, and more. Again, Google.

Do your own research, browse the group. There is a plethora of information here! It’s important to educate yourself and decide what opinions resonate with you.

Hi everyone!! A year or so ago we started doing Zoom support meetings every month or so, but it’s been a WHILE! A few people have expressed interest in doing one again, so let’s do it!

In the past, these meetings were always a low key, friendly, no judgment, supportive place where we can share our stories, advice, and see real faces of real people who are also battling this infection. If you need support and want to connect, join us!

**Please RSVP on this post** and you will be added to our group chat. *We will only send the zoom link to that chat*, just before the meeting. So please make sure you are checking Reddit around then! And please do not RSVP unless you have a legitimate intention to join (I realize life happens sometimes and people have to cancel but let’s keep the true intention there at least!)

**Zoom meeting: Saturday May 16th at 2:00pm central standard time (CST) USA**