What Is The Treatment For Chlamydia
Chlamydia can be easily cured with antibiotics. HIV-positive persons with chlamydia should receive the same treatment as those who are HIV-negative.
Persons with chlamydia should abstain from sexual activity for 7 days after single dose antibiotics or until completion of a 7-day course of antibiotics, to prevent spreading the infection to partners. It is important to take all of the medication prescribed to cure chlamydia. Medication for chlamydia should not be shared with anyone. Although medication will stop the infection, it will not repair any permanent damage done by the disease. If a persons symptoms continue for more than a few days after receiving treatment, he or she should return to a health care provider to be reevaluated.
Repeat infection with chlamydia is common. Women whose sex partners have not been appropriately treated are at high risk for re-infection. Having multiple chlamydial infections increases a womans risk of serious reproductive health complications, including pelvic inflammatory disease and ectopic pregnancy. Women and men with chlamydia should be retested about three months after treatment of an initial infection, regardless of whether they believe that their sex partners were successfully treated.
Infants infected with chlamydia may develop ophthalmia neonatorum and/or pneumonia. Chlamydial infection in infants can be treated with antibiotics.
Chlamydia Can Live In Your Gut And Reinfect You After Youre Cured
Doctors have known that chlamydia can reappear, but until now theyve been stumped as to how exactly it happens
Chlamydia is the most commonly reported sexually transmitted diseases in the United States. Thankfully, its also curable. But new research suggests that for some people, curing chlamydia doesnt prevent reinfection, even if theyre not exposed to it again. Apparently the disease can live inside your gut, and reinfect you out of the blue.
Apparently doctors have known that chlamydia can reappear in cured patients for about 80 years, but theyve been stumped as to how exactly it happens. This study points out that, in many animals, chlamydia has been found to live in the gastrointestinal tract. Thus, if gastrointestinal infection occurs in most hosts, the authors write, then it is very likely that gastrointestinal infection occurs in humans as well.
The study in question doesnt actually test this theory on any human beings. Instead it looks at data in animal models about reinfection, and the failure of certain drugs to treat chlamydia when it lives in the gut. From there, they propose that women who are infected with chlamydia could see the same kind of issues: the drugs theyre given might cure the disease genitally, but not gastrointestinally, leaving the bug to live inside waiting for the right time to strike.
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 .
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How Is Chlamydia Treated
The following are the recommended treatment regimens for chlamydia according to the Guidelines for Sexually Transmitted Diseases, released in 2015, but still considered current. Only one regimen should be chosen.
- Azithromycin 1 gram orally as a single dose
- OR
- Ofloxacin 300 mg orally twice a day for 7 days.
Put Sex On Hold During And After Chlamydia Treatment
If you were given a single dose of antibiotics to treat your chlamydia, you should not have any kind of sex for a full seven days after the day you took the medicine. If youre taking antibiotics for a week, wait another seven days after the last day of your treatment. Be sure to take all of the medicine that is prescribed for you.
Not having sex for seven days after treatment is important so you dont spread the infection to your partner or partners.
Medication stops the infection and can keep you from spreading the disease, but it wont cure any permanent damage that the infection caused before you started treatment. In women, such damage can include blocking the fallopian tubes, causing infertility.
If you still have symptoms for more than a few days after you stop taking your medicine, go back to see your doctor or other healthcare provider so they can check you again.
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How Will I Know If The Chlamydia Has Affected My Fertility
Chlamydia is just one of many factors that can affect your fertility. Most people whove had chlamydia wont become infertile or have an ectopic pregnancy . If youve had chlamydia you wont normally be offered any routine tests to see if youre fertile unless you or a partner are having difficulty getting pregnant. If youre concerned, talk to your doctor or practice nurse.
What Does A Chlamydia Test Involve
- If you have a vulva, you may be asked to take a swab around the inside of your vagina yourself.
- A doctor or nurse may take a swab during an internal examination of your vagina and cervix .
- You may be asked to provide a urine sample. Before having this test, youre advised not to pass urine for 12 hours.
- A doctor or nurse may take a swab from the entrance of the urethra .
- If youve had anal or oral sex, a doctor or nurse may swab your rectum or throat . These swabs arent done routinely on everyone.
- If you have symptoms of conjunctivitis swabs will be used to collect a sample of discharge from your eye.
A swab looks a bit like a cotton bud but is smaller and rounded. It sometimes has a small plastic loop on the end rather than a cotton tip. Its wiped over the parts of the body that could be infected. This only takes a few seconds and isnt painful, though it may be uncomfortable for a moment.
Cervical screening and routine blood tests dont detect chlamydia.
If youre not sure whether youve been tested for chlamydia, just ask.
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Analyses In A Restricted Subset Of The Main Population
Fourteen patients with CT at week 4 could be evaluated by sequence typing . All evaluated patients had the same genotype at week 4 compared with their week 0 sample . Excluding 190 patients from the main study population who were not treated according to the protocol or who reported unprotected sex, 226 patients remained in the subset analyses who contributed 183 rectal CT infections and 215 vaginal CT infections . Proportions of microbiological cure and differences between treatments were similar as described before for the main study population.
The week 1 and 2 NAAT results, the week 4 NAAT Cq values, and the week 4 culture results were used to construct 3 secondary outcomes. Evaluating secondary outcomes , cure proportions for azithromycin-treated cases were 82%91% for rectal CT and 94%99% for vaginal CT. Cure proportions for doxycycline-treated cases were 97%100% for rectal CT and 96%100% for vaginal CT. The difference between treatments was 9%15% for rectal CT and 1%2% for vaginal CT.
Chlamydia Polymerase Chain Reaction
Test of cure swab specimens collected on day 28, 42 and day 56 will be placed in Cobas® PCR Media and will be tested in batches on COBAS 4800 CT/NG . The remaining eluted DNA from COBAS 4800 will be stored at 80°C until required for further assay. For specimens collected at other time points, swabs collected will be rotated for 30 seconds in 1 ml of phosphate buffered saline and stored at 80°C until further testing required. Specimens will be subsequently extracted with MagNA Pure 96 using 200 l of the cellular suspension in conjunction with the total nucleic acid isolation kit. Eluted nucleic acid of 100 l will be tested as required.
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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:
Regular Sexually Transmitted Infection Clinic Care
Patients were recruited from regular sexually transmitted infection clinic care at 3 public health STI clinics in the Netherlands . At the regular care STI clinic testing consultation women were vaginally tested by NAAT, and women reporting unprotected anal sex or current anal symptoms were also rectally tested by NAAT. At enrollment , treatment was provided, based on the test result at T-1 . Women who were rectally CT positive were treated with a 7-day course of oral doxycycline 100 mg twice daily. Vaginal CTpositive women who were rectally untested or rectally negative received a 1-g single oral dose of azithromycin some patients with vaginal CT received doxycycline because of a contraindication to azithromycin. Azithromycin and the first doxycycline dose were directly observed.
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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.
Testing And Treating Sexual Partners
If you test positive for chlamydia, it’s important that your current sexual partner and any other recent sexual partners you’ve had are also tested and treated.
A specialist sexual health adviser can help you contact your recent sexual partners, or the clinic can contact them for you if you prefer.
Either you or someone from the clinic can speak to them, or the clinic can send them a note to let them know they may have been exposed to a sexually transmitted infection .
The note will suggest that they go for a check-up. It will not have your name on it, so your confidentiality will be protected.
Page last reviewed: 01 September 2021 Next review due: 01 September 2024
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What Std Does Doxycycline Treat
Doxycycline is effective against the STIs chlamydia and syphilis, but not commonly for gonorrhea .
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Randomization And Sequence Generation Allocation Concealment And Blinding
A computer-generated randomization sequence will be created by an independent statistician. Blinded therapy will be prepared by an independent organization and labelled with individual kit numbers according to randomization. Study drugs will be packaged into individually numbered kits stored by independent site pharmacists. All tablets will be identical in appearance and feel, and all medications will be packaged identically to maintain blinding. Participants, physicians, nurses, trial statistician and all other trial staff will be masked to treatment group. The effectiveness of blinding will be tested at completion of the trial when participants will be asked to indicate which treatment they thought they received .
The side-effect profiles of the drugs will have negligible impact on blinding. They have been widely used for chlamydia for decades at the dosages we will be using. Their side-effect profiles are well established and similar including minor gastrointestinal upset . Photosensitivity may occur for doxycycline but is more common with longer or higher dosages . Rash is a rare side effect for each drug, occurring in 0.11% of cases . Our packaging will clearly state sunscreen should be used and exposure to sun minimalized, thereby reducing the risk of photosensitivity. We examined the side-effect data from treatment trials for urethral/cervical chlamydia and found that among 17 trials, there was no difference in side-effects .
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Enrollment At Regular Care Treatment
Women were enrolled at T0, the treatment visit. Eligible were nonpregnant adult women who had a vaginal or rectal CT infection were not infected with human immunodeficiency, syphilis, or Neisseria gonorrhoeae and who had not used antibiotics since T-1. Participation started after written informed consent.
How Do You Know If Chlamydia Is Gone After Treatment
Your chlamydia symptoms should improve within a week of completing your course of antibiotics.
You do not need an immediate follow-up test to check if your chlamydia treatment has worked, as dead chlamydia bacteria may be detected 3 to 5 weeks after treatment, which would give a false positive result. But, if you have a rectal infection, you should have a test after treatment is completed.
If you are under 25 and have tested positive for chlamydia, it is recommended you take a repeat test 3 months after completing your treatment, to check you have not caught chlamydia again.
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What Happens If Chlamydia Isn’t Treated
Only some people who have chlamydia will have complications. If chlamydia is treated early, its unlikely to cause any long-term problems. But, without proper treatment, the infection can spread to other parts of the body. The more times you have chlamydia the more likely you are to get complications.
- If you have a vulva, chlamydia can spread to other reproductive organs causing pelvic inflammatory disease . This can lead to long-term pelvic pain, blocked fallopian tubes, infertility and ectopic pregnancy .
- In people with a vulva, chlamydia can also cause pain and inflammation around the liver, though this is rare. This usually gets better with the correct antibiotic treatment.
- If you have a penis, chlamydia can lead to infection in the testicles. If this isnt treated, theres a possibility it could affect your fertility but more research is needed to understand how likely this is.
- Rarely, chlamydia can lead to inflammation of the joints. This is known as Sexually Acquired Reactive Arthritis and is sometimes accompanied by inflammation of the urethra and the eye. This is more likely to occur in people with a penis than people with a vulva.
How Long Does Azithromycin Take To Cure Chlamydia
It usually takes approximately 7 days for azithromycin to cure chlamydia. However, it can take up to 2 weeks for the infection to go away completely.
Avoid having sex during treatment or until the infection has cleared. Youll want to make sure its completely cured, or else youll risk passing it to someone else.
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How Is Chlamydia Diagnosed
Chlamydia can be diagnosed with either a first-catch urine test or a swab collected from the endocervix or vagina in women, or a first-catch urine test or a swab collected from the urethra in men.
Self-collected vaginal swab testing is available and many women find this screening strategy highly acceptable.
- Geisler WM, Uniyal A, Lee JY, et al. Azithromycin versus Doxycycline for Urogenital Chlamydia trachomatis Infection. N Engl J Med. 2015 373:2512-2521. doi:10.1056/NEJMoa1502599
- Workowski, K, Bolan G. U.S. Department of Health and Human Services. Sexually Transmitted Diseases Treatment Guidelines, 2015. Morbidity and Mortality Weekly Report.
- WHO Guidelines for the Treatment of Chlamydia trachomatis. Geneva: World Health Organization 2016. 4, RECOMMENDATIONS FOR TREATMENT OF CHLAMYDIAL INFECTIONS. Available from:
- Chlamydia Treatment and Care. Centers for Disease Control and Prevention https://www.cdc.gov/std/chlamydia/treatment.htm
- Chlamydia Treatment Information Sheet. Wisconsin Department of Health Services.
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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