Why Is Chlamydia Treatment So Important
If you are diagnosed with chlamydia, it is vitally important you get the right treatment promptly. You must take the medication correctly, and also make sure you follow specific advice about what to do, and what not to do, while taking the medication.
In the UK, doctors and other healthcare providers are advised to follow the evidence based treatment recommendations for chlamydia, published by The British Association of Sexual Health & HIV . These recommendations were in September 2018, and are outlined in this article.
- Treating chlamydia promptly and effectively, will reduce the risk of long complications.
- Leaving chlamydia untreated, or partially treated, may result in serious health problems.
Chlamydial infection, causes intense inflammation within certain body tissues which become, red, swollen, and then scar tissue may develop. A range of unpleasant symptoms, can then develop, as well as certain medical conditions.
Does Azithromycin Cure Chlamydia
Cure rates of 97% were reported in an analysis of 12 randomized clinical trials that investigated the use of azithromycin 1 gram for the treatment of chlamydia. That means for every 100 people with chlamydia who take azithromycin, 97 will be cured and 3 will not be cured.
This relies on the person with chlamydia taking azithromycin exactly as directed and not sharing the medication with anyone. Any sexual partners must be also treated.
Although azithromycin cures chlamydia in most people, it will not repair any permanent damage done to tissues by the disease.
If you have been symptomatic with chlamydia before treatment and your symptoms continue for more than a few days after receiving treatment, then ask to be re-evaluated by your health care provider.
Unfortunately, repeat infection with chlamydia is common. This means that even though azithromycin has cured your current infection with chlamydia, this does not mean you will not get chlamydia again. If your sexual partners have not been appropriately treated, you are at high-risk for reinfection. Having chlamydia multiple times puts women at high risk of fertility problems, ectopic pregnancy, and pelvic inflammatory disease. Infants born to mothers who are infected with chlamydia may develop chlamydial conjunctivitis and/or pneumonia. Chlamydial infection in infants can be treated with antibiotics.
Doxycycline Resistance And M Genitalium
Information on antimicrobial susceptibility of M. genitalium is scarce because of the limited number of strains isolated from clinical samples. Studies reporting MICs of doxycycline usually found low MIC values, i.e. 5 strains with MICs ranging from0.008 to 0.031 mg/L and 14 strains with MICs ranging from 0.06 to 0.12 mg/L . However, an in vitro antimicrobial susceptibility testing study conducted using both broth dilution and quantitative PCR showed an MIC range of 0.0631 mg/L indicating that the strains displayed reduced susceptibility to doxycycline but that these isolates remained rare. Finally, a recent larger study showed that 2 isolates out of 103 displayed MIC> 8 mg/L while for other isolates, MICs ranged from< 0.125 to 2 mg/L. However, doxycycline MICs did not correlate with treatment outcomes in this study. As far as molecular detection of mutations mediating resistance is concerned, macrolides and fluoroquinolones were mainly studied and to our knowledge, tetracycline resistance-associated mutations have not so far been identified in M. genitalium. Altogether, MICs mostly indicated susceptibility of M. genitalium to doxycycline and the rare isolates with reduced susceptibility cannot explain the poor efficacy of doxycycline in the treatment of M. genitalium infections., Considering the emergence of MDR M. genitalium strains, it thus appears important to elucidate reasons other than poor patient compliancefor the poor efficacy of doxycycline.
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Side Effects Requiring Immediate Medical Attention
Along with its needed effects, azithromycin may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur while taking azithromycin:
- Pneumonia, strep throat, tonsillitis, and skin infections: Take 500 mg by mouth on day 1, followed by 250 mg by mouth once a day on days 2 through 5.
- Sinus infections: Take 500 mg by mouth once a day for 3 days.
- COPD flare-up: There are two sets of directions you can follow. You can take 500 mg by mouth once a day for 3 days, OR you can take 500 mg by mouth on day 1, followed by 250 mg by mouth once a day on days 2 through 5.
- Chancroid, chlamydia, and infections of the urethra and cervix not caused by gonorrhea: Take 1,000 mg by mouth one time only.
- Gonorrhea: Take 2,000 mg by mouth one time only.
- Middle ear infection: There are three sets of directions you can follow: Take 30 mg/kg by mouth one time only Take 10 mg/kg by mouth once a day for 3 days OR Take 10 mg/kg by mouth on day 1 and then take 5 mg/kg by mouth once a day on days 2 through 5.
- Sinus infections: Take 10 mg/kg by mouth once a day for 3 days.
- Pneumonia: Take 10 mg/kg by mouth on day 1 and then take 5 mg/kg by mouth once a day on days 2 through 5.
- Strep throat and tonsillitis: Take 12 mg/kg by mouth once a day for 5 days.
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How Do You Take Azithromycin Chlamydia Treatment
When you buy Azithromycin online or from you local pharmacy, always take the medication exactly as your doctor and pharmacist has prescribed.
Azithromycin tablets can be taken with or without food, and it is suggested to take Azithromycin with half a glass of water.
The normal dosage for chlamydia treatment is 1000mg all in one go, then 500mg daily for two days. The entire course is 3 days long.
Do not have sex until you have completed all of the treatment.
After the course of treatment is complete it is possible that you could test positive for Chlamydia for up to 8 weeks despite no longer being infectious.
Is Azithromycin Better Than Doxycycline At Curing Chlamydia
STD guidelines still favor azithromycin over doxycycline for the treatment of chlamydia. This is because of the following reasons:
- Cure rates of azithromycin and doxycycline are similar, 97% and 98-100% respectively, according to a meta-analysis of 12 trials.
- Azithromycin is given as a single dose, doxycycline needs to be given for seven days, either as a once-daily or twice-daily dose.
- The dose of azithromycin can be easily supervised if need be it is much harder to supervise seven days of once daily or twice daily doxycycline treatment
- People are more likely to take a single dose of azithromycin than finish a seven-day course of doxycycline.
Recently, some reports have suggested that doxycycline may be more effective than azithromycin, particularly when medication adherence can be assured. There is also some concern that azithromycin may not be as effective for anogenital chlamydial infections.
Usual Adult Dose For Tonsillitis/pharyngitis
Immediate-release: 500 mg orally as a single dose on day 1, followed by 250 mg orally once a day on days 2 to 5Use: Treatment of pharyngitis/tonsillitis caused by Streptococcus pyogenes as an alternative to first-line therapy in patients who cannot use first-line therapyIDSA Recommendations:Individuals with penicillin allergy: 12 mg/kg orally once a day-Maximum dose: 500 mg/day-Duration of therapy: 5 daysUse: Treatment of Group A streptococcal pharyngitis
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Ophthalmia Neonatorum Caused By C Trachomatis
A chlamydial etiology should be considered for all infants aged 30 days who experience conjunctivitis, especially if the mother has a history of chlamydial infection. These infants should receive evaluation and age-appropriate care and treatment.
Preventing Ophthalmia Neonatorum Caused by C. trachomatis
Neonatal ocular prophylaxis with erythromycin, the only agent available in the United States for this purpose, is ineffective against chlamydial ophthalmia neonatorum . As an alternative, prevention efforts should focus on prenatal screening for C. trachomatis, including
Neonates born to mothers for whom prenatal chlamydia screening has been confirmed and the results are negative are not at high risk for infection.
Erythromycin base or ethylsuccinate 50 mg/kg body weight/day orally, divided into 4 doses daily for 14 days*
* An association between oral erythromycin and azithromycin and infantile hypertrophic pyloric stenosis has been reported among infants aged < 6 weeks. Infants treated with either of these antimicrobials should be followed for IHPS signs and symptoms.
Although data regarding use of azithromycin for treating neonatal chlamydial infection are limited, available data demonstrate that a short therapy course might be effective . Topical antibiotic therapy alone is inadequate for treating ophthalmia neonatorum caused by chlamydia and is unnecessary when systemic treatment is administered.
Do I Need To Get Tested Again After Taking Azithromycin
You should get tested two weeks after you finish taking azithromycin, because the effectiveness of azithromycin has reduced over recent times. To get tested, you should visit your local GUM clinic, or buy an STD test kit online. You should also have another chlamydia test if symptoms persist two weeks after having taken the treatment, or you have not abstained from sexual activity for 7 days after having completed your treatment course. Those under the age of 25 who are sexually active are recommended to test for chlamydia on a regular basis.
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Is Treatment Always Necessary For Chlamydia
Yes, treatment is necessary for chlamydia, particularly in women of childbearing age, because it reduces the risk of chlamydia-associated ectopic pregnancy, fertility problems, and the transmission of chlamydia to neonates during birth. In women, of all ages, chlamydia treatment reduces the risk of pelvic inflammatory disease.
In men, treatment for chlamydia stops them from infecting or reinfecting sexual partners with the bacteria.
Treat any person testing positive for chlamydia with a recommended course of antibiotics promptly. Delays in treatment have been associated with complications, such as pelvic inflammatory disease.
How Long Does It Take
It takes about one week for azithromycin to completely cure a chlamydial infection, and in some cases it can take up to two weeks for the infection to clear.
If you are sexually active during this time, you can pass the infection to your partner, even if you have no symptoms. For these reasons, you should avoid having sex of any kind during treatment.
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Long Term Complications Of Chlamydia In Males
In men, chlamydia can be diagnosed from a urine test or swab, even if you have no symptoms. In 50% of men who test positive, chlamydia symptoms are absent. However if untreated, because chlamydia also causes inflammation in the male genital tract, this may result in the following.
- Urethritis pain within the penis and on passing urine, often with discharge
- Epididymo-orchitis painful, swollen testicles
- Prostatitis a painful, swollen, prostate gland
- Chlamydial infection also affects male fertility. Semen is poorer quality, and as it is packed full of inflammatory cells, sperm have less ability to swim freely.
Treating Newborns And Infants
Chlamydia infections in newborns and infants are far less common today due to the routine screening of STIs in people with pregnancy. If an infection occurs, it typically happens during childbirth as the baby passes through the mother’s birth canal.
Chlamydia in newborns is most often recognized when the child develops conjunctivitis , typically five to 12 days after birth. Some babies may have no such symptoms and instead develop pneumonia with fever between the ages of one and three months.
If a chlamydia infection is confirmed, the baby would be treated with an antibiotic called erythromycin, The dose is calculated in milligrams per kilogram of the baby’s body weight.
In cases of chlamydial pneumonia, oral azithromycin can be used as an alternative.
|Treatment Recommendations for Newborns and Infants|
|50 mg/kg per day delivered by mouth in four equally divided doses over 14 days|
|Alternative||Azithromycin||20 mg/kg per day delivered by mouth in a single dose over three days|
Erythromycin, while safer for newborns and infants, is only around 80% effective in clearing C. trachomatis. As a result, a second round of antibiotics may be needed to fully clear the infection.
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Does Azithromycin Work For Chlamydia
Azithromycin works to treat genital chlamydia in both men and women by stopping the bacteria from multiplying.
That means that for every 100 people who take azithromycin to treat chlamydia, 97 will be cured and three will not be cured.
In order to effectively treat chlamydial infections, azithromycin should be taken as prescribed and until the dosage is completed.
Ending the medication early increases the chance that the bacteria will not be completely killed off.
What Are Some Other Side Effects Of Azithromycin Single
All drugs may cause side effects. However, many people have no side effects or only have minor side effects. Call your doctor or get medical help if any of these side effects or any other side effects bother you or do not go away:
- Stomach pain or diarrhea.
- Upset stomach or throwing up.
These are not all of the side effects that may occur. If you have questions about side effects, call your doctor. Call your doctor for medical advice about side effects.
You may report side effects to the FDA at 1-800-332-1088. You may also report side effects at https://www.fda.gov/medwatch.
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Do I Need To Have A Test To Check That The Chlamydia Has Gone
If you take the treatment according to the instructions, you wont usually need a test to check the chlamydia has gone.
If youre aged under 25, you should be offered a repeat test 3 months after finishing the treatment. This is because youre at a higher risk of getting chlamydia again.
Whatever your age, you may need a repeat test or more treatment if:
- you think youve come into contact with chlamydia again
- you had sex without a condom with a partner before the treatment for both of you was finished
- you didnt complete the treatment or didnt take it according to the instructions
- the signs and symptoms dont go away
- your test was negative but you develop signs or symptoms of chlamydia
- youre pregnant.
A repeat test can be done 56 weeks after the first test.
If the chlamydia was in your rectum , you may need another test around 3 weeks after finishing the treatment. Your doctor, nurse or clinic will let you know if you need another test.
You can go back to the doctor, nurse or clinic if you have any questions or need advice on how to protect yourself from infection in the future.
What Are Some Things I Need To Know Or Do While I Take Azithromycin Single
For all patients taking azithromycin single-dose packet:
- Tell all of your health care providers that you take azithromycin single-dose packet. This includes your doctors, nurses, pharmacists, and dentists.
- Do not use longer than you have been told. A second infection may happen.
- A severe and sometimes deadly reaction has happened. Most of the time, this reaction has signs like fever, rash, or swollen glands with problems in body organs like the liver, kidney, blood, heart, muscles and joints, or lungs. If you have questions, talk with the doctor.
- This medicine may cause a type of abnormal heartbeat . If this happens, the chance of other unsafe and sometimes deadly abnormal heartbeats may be raised.
- If you have myasthenia gravis, talk with your doctor. Call your doctor if your signs get worse. Signs of myasthenia gravis have also happened in people who do not have it. Call your doctor right away if you have new or worse muscle weakness, trouble chewing or swallowing, trouble breathing, droopy eyelids, or change in eyesight like blurred eyesight or seeing double.
- If you are 65 or older, use azithromycin single-dose packet with care. You could have more side effects.
- Tell your doctor if you are pregnant, plan on getting pregnant, or are breast-feeding. You will need to talk about the benefits and risks to you and the baby.
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What Do I Need To Tell My Doctor Before I Take Azithromycin Single
- If you have an allergy to azithromycin or any other part of azithromycin single-dose packet.
- If you are allergic to azithromycin single-dose packet any part of azithromycin single-dose packet or any other drugs, foods, or substances. Tell your doctor about the allergy and what signs you had.
- If you have turned yellow or had liver side effects with azithromycin single-dose packet before.
- If you have any of these health problems: Long QTc on ECG or other heartbeat that is not normal, slow heartbeat, or low potassium or magnesium levels.
- If you have heart failure .
- If you have ever had a certain type of abnormal heartbeat .
- If you are taking any drugs that can cause a certain type of heartbeat that is not normal . There are many drugs that can do this. Ask your doctor or pharmacist if you are not sure.
This is not a list of all drugs or health problems that interact with azithromycin single-dose packet.
Tell your doctor and pharmacist about all of your drugs and health problems. You must check to make sure that it is safe for you to take azithromycin single-dose packet with all of your drugs and health problems. Do not start, stop, or change the dose of any drug without checking with your doctor.