M. genitalium is clearly associated with both acute and persistent/chronic urethritis in men and in female associated with cervicitis or Pelvic inflammatory disease. Anyone who receive a diagnosis of M. genitalium infection should be treated for the infection. Available observational and randomized trial data have shown that azithromycin is superior to doxycycline in treating M. genitalium–associated urethritis, and M. genitalium should be suspected in cases of NGU that persist or recur after therapy with doxycycline. Despite the apparent superiority of azithromycin, there are increasing concerns over emerging resistance to this therapeutic agent, and only moxifloxacin has demonstrated 100% cure rates