Summary Of The Evidence
There is no evidence relating to patient values and preferences but the Guideline Development Group agreed that there is probably no variability in the values people place on the outcomes. Research related to other conditions indicates that adherence may be improved with simpler medication regimens. The GDG therefore agreed that azithromycin may be more acceptable to patients since it is a single dose regimen . There is little to no evidence for equity issues and feasibility. Resistance in other infections that often co-occur with chlamydia may restrict the use of some medicines, such as ofloxacin. For many of these medicines, costs may differ between countries in places with high incidence of chlamydia, the cost differences between azithromycin and doxycycline may be large due to greater numbers of people requiring treatment.
In summary, there was moderate quality evidence for trivial differences in benefits and harms between azithromycin and doxycycline, and although the cost of azithromycin is higher, the single dose may make it more convenient to use than doxycycline. While the differences are also trivial with the other medicines, the evidence is low quality and these are therefore provided as alternatives, with the exception of delayed-release doxycycline, which is currently expensive.
See for list of references of reviewed evidence, and for details of the evidence reviewed, including evidence profiles and evidence-to-decision frameworks .
Why Doctors Dont Recommend This Yet
In most instances, healthcare professionals treat STIs based either on symptoms that you present with, the results of laboratory tests, or both. As STIs dont always have symptoms , it is recommended that people who have sex that puts them at risk test frequently and treat any STIs as soon as they are detected. It is also important to make sure that recent partners are treated.
Taking antibiotics prophylactically is not recommended yet, mainly due to major concerns about the development of antimicrobial resistance. Taking a drug and then catching an infection that easily develops resistance to it could further raise rates of resistance to that drug in the wider community. Resistance means that medications that were once effective at treating certain bacterial infections lose their ability to do so. Essentially, the bacterium outsmarts the medication, rendering it ineffective.
Resistant strains circulate within the population, resulting in the failure of treatments that had previously worked even in people not using antibiotics to prevent STIs. Gonorrhoea has evaded multiple classes of antibiotics, and few options remain available. Most recently, it has become resistant to azithromycin and therefore, this antibiotic is no longer recommended for treatment.
However, when it comes to using specific antibiotics to prevent specific STIs, its not all bad news see more under What about resistance?
Treatment For Chlamydia Is Quick And Easy
Two antibiotics are most often used for treating chlamydia:
- Azithromycin The main treatment for chlamydia is one gram of azithromycin, taken one time, says , deputy director of clinical services for public health with the Seattle and King County HIV and STD Program in Washington. That one gram comes as either two pills or four pills. It is not expensive.
- Doxycycline If your doctor prescribes doxycycline, you will take two pills daily for one week. It costs somewhat more than azithromycin.
Antibiotics can also cure chlamydia in infants, who can get the infection from their mothers, and treatment is essential for them. Without treatment, infants infected with chlamydia can develop conjunctivitis, which can cause blindness, or pneumonia, which can be fatal.
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What Is Sti Prophylaxis
One approach would be to take a daily dose of the antibiotic this would be considered pre-exposure prophylaxis , meaning that there may be enough of the antibiotic in the body before exposure occurs. Another way would be to take a dose soon after sex. In this case, the antibiotic would work as a form of post-exposure prophylaxis preventing bacterial growth and making it less likely for exposure to lead to infection.
This factsheet focuses specifically on using antibiotics to prevent bacterial STIs, which is still an experimental technique. It is not to be confused with HIV PrEP and PEP, which are effective forms of preventing HIV, as outlined below.
How Do I Know If I Have Chlamydia
If you suspect you have chlamydia, your doctor may want to test cervical or penile discharge or urine using one of several available methods.
In most cases of chlamydia, the cure rate is 95%. However, because many women don’t know they have the disease until it has caused serious complications such as pelvic inflammatory disease, sexually active women under age 25 and others at higher risk should be tested for chlamydia once a year during their annual pelvic exam even if they dont have symptoms.
Pregnant women should also be tested as part of their routine lab work.
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What Happens If You Dont Get Treated For Chlamydia
Even though chlamydia is common and doesnt usually cause any symptoms, it can become a big deal if its not caught and treated early.
Chlamydia can spread to your uterus and fallopian tubes if it goes untreated for a long time. This can cause you to have pelvic inflammatory disease . PID can cause permanent damage that leads to pain, infertility, or ectopic pregnancy. So getting tested regularly for chlamydia really lowers your chances of getting PID.
Having chlamydia may increase your chances of getting or spreading HIV.
If you have chlamydia during your pregnancy and dont treat it, you can pass it to your baby when youre giving birth. Chlamydia can also cause eye infections and pneumonia in newborns, and it also increases the risk of delivering your baby too early.
Testing and treatment for chlamydia is quick, easy, and the best way to avoid all of these problems.
Study Design And Setting
This is a double-blind RCT. Given our primary outcome is treatment efficacy, our trial is double blind to minimize bias that could arise as a result of the different dosing regimens of the two drugs . For example: i) it is possible that taking a 7-day course of daily doxycycline rather than a single dose of azithromycin may deter people from resuming sexual activity while taking treatment, thereby reducing their risk of a new infection, and ii) participants could be less adherent to a 7-day regimen which could impact efficacy . The trial will be conducted within sexual health clinics in Victoria and New South Wales in Australia and in accordance with the Declaration of Helsinki. The trial was approved by the Alfred Hospital Ethics Committee .
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Management Of Sex Partners
Sex partners should be referred for evaluation, testing, and presumptive treatment if they had sexual contact with the partner during the 60 days preceding the patients onset of symptoms or chlamydia diagnosis. Although the exposure intervals defining identification of sex partners at risk are based on limited data, the most recent sex partner should be evaluated and treated, even if the time of the last sexual contact was > 60 days before symptom onset or diagnosis.
Home Remedies For Chlamydia
There are several home remedies for chlamydia and a number of websites claim that these home remedies can cure chlamydia. While some of the home remedies have been shown to have antibacterial properties, antibiotics are the only proven cure for chlamydia. It isnt worth the risk of infertility or illness to not treat chlamydia.
If you experience symptoms, some of these home remedies may be effective for symptom relief, but they cannot cure the infection itself.
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When Would Be The Right Dosage And Time To Take Antibiotics To Prevent An Sti
Based on the limited research available, those at risk for exposure to bacterial STIs would either need to take a 100mg pill of doxycycline daily or take a 200mg dose after a sexual encounter .
A small qualitative study with Australian men who have sex with men indicated a preference for daily dosing. However, taking doxycycline as doxyPEP as opposed to taking it daily might be best in terms of reducing the amount of antibiotics taken.
As there are currently no clinical guidelines on dosage or formulation of doxycycline for STI prophylaxis, further research is required to answer this question with more certainty. More research is also needed regarding STI prophylaxis in people taking HIV PrEP, and for people living with HIV who are taking antiretrovirals.
Does Taking Antibiotics To Prevent Stis Work
While there is very limited research on the topic, some findings support the concept of using an antibiotic called doxycycline preventatively.
Doxycycline prevents bacteria from reproducing and effectively treats various bacterial infections, including pneumonia, gum disease, skin infections and some STIs. Doxycycline is also used to prevent malaria infection. There is no evidence to suggest that using any other antibiotics than doxycycline would prevent STIs.
Research has largely been carried out with gay men who have multiple sexual partners and dont use condoms, as they represent the group at highest risk for recurrent bacterial STIs.
A small US pilot study randomised 30 gay men living with HIV, who had had syphilis twice or more since their HIV diagnosis, to one of two groups. Men who took 100mg of doxycycline by mouth daily were 73% less likely to test positive for gonorrhoea, chlamydia or syphilis during 48 weeks of follow-up, compared to men who had been provided with monetary incentives to remain STI free. There was no significant difference in reported risk behaviours between the two groups. This is an example of doxycycline pre-exposure prophylaxis, or doxyPrEP.
The gonorrhoea finding was not surprising: around half of the French and UK strains of gonorrhoea, and around a quarter of those in the US, are resistant to tetracycline antibiotics . However, these antibiotics are not usually used in the treatment of gonorrhoea because of the high rates of resistance.
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Is Treatment Different For Pregnant Women With Gonorrhea
The medications used for pregnant women with gonorrhea are essentially the same as the medications used for non-pregnant women.
Treatment is necessary to prevent disease transmission to, or complications for, the baby.
Gonorrhea in babies often manifests as conjunctivitis, or pink eye. Some states require that all newborns are given antibiotic eye drops, such as erythromycin, as a preventive measure against the disease.
Pregnant women who are diagnosed with gonorrhea should be tested for other STIs as well.
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Chlamydia And Gonorrhea Symptoms
The symptoms of chlamydia and gonorrhea overlap, so it can be difficult to differentiate between the two unless you visit your healthcare provider or take a test for chlamydia or gonorrhea.
The overlapping symptoms for chlamydia and gonorrhea in men and women include:
- A burning sensation during urination
- Abnormal genital or rectal discharge
- Pain in the rectum
With both chlamydia or gonococcal infections , men might also experience swelling and pain in the testicles and/or scrotum.
In women, both a gonorrhea and chlamydia infection might be mistaken for a yeast infection. Women may also experience painful periods, bleeding between periods, pain during sex, or abdominal pain.
Although the symptoms overlap, the discharge caused by chlamydia vs. gonorrhea can vary slightly. For a chlamydia infection, a womanÃÃÂ¢s vaginal discharge might have a strong odor and yellowish tint. Men might have a cloudy or clear discharge. With gonorrhea, both women and men may experience green, yellow, or white discharge.
If youÃÂ¢re a woman experiencing abnormal vaginal discharge or a man with abnormal penile discharge, be sure to consult your healthcare provider as soon as possible as this is a common sign of an infection.
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Doxycycline After Unprotected Sex Significantly Reduced Stis
Study of Men Who Have Sex with Men and Transgender Women Stopped Early for Effectiveness
Image by National Institute of Allergy and Infectious Diseases, National Institutes of Health
A significant proportion of bacterial sexually transmitted infections gonorrhea, chlamydia, or syphilis were prevented with a dose of doxycycline after unprotected sex, according to preliminary results of a clinical trial that closed early because it was very effective for men who have sex with men and transgender women who are living with HIV or are taking HIV pre-exposure prophylaxis .
The results of the clinical trial, conducted in San Francisco and Seattle, have been eagerly anticipated by public health officials and clinicians who are looking for new ways to prevent STIs, which have been on the rise in the United States and many other parts of the world for the past six years.
Researchers examined an approach known as doxycycline post-exposure prophylaxis , in which people take 200 milligrams of the antibiotic doxycycline within three days of having sex without a condom.
They recruited from public health clinics in San Francisco and Seattle. To qualify, participants had to have had gonorrhea, chlamydia or syphilis, in the previous year. Participants were randomized to receive doxycycline or no doxycycline in an open-label study design.
Researchers said the data support the effectiveness of DoxyPEP to prevent STIs in the population they studied.
Parents Have A Role In Chlamydia Prevention
Parents can do two main things to help their kids avoid getting chlamydia and other sexually transmitted infections , says Dombrowski. These two things are:
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Can These Stds Still Be Treated
As of 2020, the CDC recommends an injection of ceftriaxone for uncomplicated cases of gonorrhea.
Syphilis can be treated with penicillin, but Klausner says there have been shortages of the antibiotic in the United States and around the world. It can also be treated with azithromycin, though it has shown some resistance to this antibiotic, he says.
Chlamydia still responds to several antibiotics, including doxycyclin, erythromycin, amoxicillin, and azithromycin. Nevertheless, public health officials must be vigilant, says Englund.
âAny time you see resistance rising , you need to look at the others for potential rise and make sure it doesnât start to develop there as well,â she says.
antibiotic-resistant strains of gonorrhea poses some challenges for successful treatment.
Thats why youll generally receive both an injection and oral dose of antibiotics. If the first treatment approach doesnt work, a healthcare professional will prescribe another antibiotic, which youll take once or twice a day for 7 days.
Its important to take all of your medication to completely treat the infection, even if your symptoms go away before you finish your prescription.
If you continue to have symptoms after taking your antibiotics as prescribed, contact a healthcare professional as soon as possible so they can try a different treatment.
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What Are The Symptoms Of Chlamydia
Many people with chlamydia have no symptoms at all, and their infection is only picked up with a screening test.
Guidelines currently recommend that all women under the age of 25 get screened for chlamydia every year. Older women at increased risk for an infection, such as those with a new sex partner, more than one sex partner, a sex partner with concurrent partners, or a sex partner who has a sexually transmitted infection, should also be screen regularly.
Although routine screening for chlamydia in young men is not currently recommended, it should be considered in populations with a high prevalence of chlamydia or those at high risk for chlamydia .
Some people may have symptoms.
Women may notice an unusual vaginal discharge or problems when urinating , such as pain or burning, an increased need to urinate pain during sex bleeding between periods or after sex lower abdominal , or pelvic pain or cramps or.
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Cules Son Los Sntomas De La Infeccin Por Chlamydia Trachomatis
Las infecciones por Chlamydia trachomatis en etapa temprana a menudo causan pocos signos o síntomas, o ninguno. Incluso cuando se producen signos y síntomas, suelen ser leves, lo que hace que sean fáciles de pasar por alto. Los signos y síntomas de la infección por Chlamydia trachomatis pueden incluir:
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A Complete Guide On Using Doxycycline For Chlamydia
- Oyewale Oyelami
Being diagnosed with chlamydia can be embarrassing and leave you scared and alone. However, treatments available can help you eliminate the infection and move on with your life. One such treatment is doxycycline, which is an antibiotic. Read on to learn more about using doxycycline for chlamydia.
Need help with Chlamydia?
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Whats The Treatment For Chlamydia
Chlamydia is usually easy to get rid of. Your nurse or doctor will get you antibiotics to treat the infection. Sometimes you only have to take one dose of medication. Another chlamydia treatment lasts for 7 days. Your doctor will help you figure out which treatment is best for you.
If youre treated for chlamydia, its really important for your sexual partners to get treated also. Otherwise, you can keep passing the infection back and forth, or to other people. Sometimes your doctor will give you medicine for both you and your partner.