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Single Dose Doxycycline For Chlamydia

Will I Need To Go Back To The Clinic

Doxycycline – A Tetracycline Class Antibiotic

If you take your antibiotics correctly, you may not need to return to the clinic.

However, you will be advised to go back for another chlamydia test if:

  • you had sex before you and your partner finished treatment
  • you forgot to take your medication or didn’t take it properly
  • your symptoms don’t go away
  • you’re pregnant

If you’re under 25 years of age, you should be offered a repeat test for chlamydia 3 to 6 months after finishing your treatment because you’re at a higher risk of catching it again.

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.

syphilis

Use In Pregnancy And Breastfeeding

Doxycycline is labelled as Pregnancy Category D in the FDA classification. So, doxycycline should be avoided during pregnancy because of severe adverse effects including teratogenicity, permanent yellowish-brown teeth discoloration after in utero exposure and rare fatal hepatotoxicity, and is therefore contraindicated past the fifth week of pregnancy. However, despite this categorization as a class D agent, doxycycline was FDA approved for use in pregnant women following exposure to biothreat agents, including Bacillus anthracis, Yersinia pestis and Francisella tularensis.

Recently, a systematic review of doxycycline in pregnant women revealed a safety profile significantly different from that of tetracycline with no correlation between the use of doxycycline and teratogenic effects during pregnancy or dental staining in children.

Although doxycycline produces measurable milk levels, it is not contraindicated during the nursing period.

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Why Change Advice About Chlamydia Treatment

In the past, chlamydia was often treated with a single dose of the antibiotic azithromycin.

Azithromycin was felt to be a good first choice, because taking just the 1mg dose results in very good antibiotic levels in the blood stream for several days, without the need to take further tablets.

Azithromycin taken as a single dose, was also ideal, because it was easier for patients to take all their treatment at once. The alternative treatment option, was a 7-day course of doxcycline, but in fact, many people never finish a 7-day course of antibiotics.

In a clinic setting, the doctor/nurse would often watch you swallow the azithromycin tablets there and then, meaning this ensured the complete regime had been taken.

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Put Sex On Hold During And After Chlamydia Treatment

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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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Chlamydia Treatment And Prevention

Milly DawsonSanjai Sinha, MDShutterstock

Chlamydia is easy to cure. If you test positive for chlamydia, basically you take an antibiotic, says Jill Rabin, MD, cochief in the division of ambulatory care for womens health programs and prenatal care assistance program services for Northwell Health in New Hyde Park, New York.

Your partner must take an antibiotic, too, to keep them from reinfecting you, she says.

You have to have your partner treated, and if you have more than one partner, they should all be treated, says Dr. Rabin, regardless of your partners genders.

Even if you dont have chlamydia now, its wise to learn how to protect yourself so you wont develop this common infection in the first place. In women, chlamydia can create serious health problems, including infertility. Besides, no one ever wants to have a sexually transmitted disease and then have to tell other people about it.

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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Predictors Of Treatment Failure

In univariate analysis, failure of extended azithromycin 1.5g was associated with the following: pre-treatment resistance, reporting male sexual partners, number of sexual partners, and prior use of azithromycin for this NGU episode . Treatment failure was not associated with the following: sex outside Australia, bacterial load, and risk of reinfection. In multivariate analysis, factors that remained significantly associated with treatment failure were pre-treatment resistance and being MSM .

Predictors of Failure of Extended Azithromycin 1.5g to Treat Urethral Mycoplasma genitalium Infection in Patients With Test of Cure 14100 Days After Treatment and Pre-Treatment Genotype

Patient Group .

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Can You Get Chlamydia More Than Once

Gonorrhea & Chlamydia Trachomatis â Infectious Diseases | Lecturio

Yes, you can get the infection even if youve successfully treated it already.

A sexual partner who has chlamydia can transmit it to you again, even if youve already had it and treated it.

You can also get chlamydia again if it wasnt fully treated the first time. This can happen if you stop taking the necessary treatment. Its important to complete the antibiotics youve been given, even if your symptoms get better.

The CDC recommends getting tested 3 months after treatment of your initial infection to ensure the infection is cleared.

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How Do I Store And/or Throw Out Azithromycin Single

  • Store at room temperature.
  • Store in a dry place. Do not store in a bathroom.
  • Keep all drugs in a safe place. Keep all drugs out of the reach of children and pets.
  • Throw away unused or expired drugs. Do not flush down a toilet or pour down a drain unless you are told to do so. Check with your pharmacist if you have questions about the best way to throw out drugs. There may be drug take-back programs in your area.

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What Happens If Chlamydia Goes Untreated

If a person is not treated for chlamydia, complications may occur. Women frequently develop pelvic inflammatory disease . PID can cause infertility , chronic pelvic pain, tubal pregnancies, and the continued spread of the disease. In men, untreated chlamydia can cause urethral infection and complications such as swollen and tender testicles. Chlamydia infection during pregnancy may result in premature rupture of membranes, preterm delivery and possible tubal pregnancy in a small percent of women. In addition, chlamydia can cause conjunctival and pneumonic infection in the newborn. Persons with a chlamydia infection have an increased chance of getting other infections such as gonorrhea or HIV.

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Does Amoxicillin Fit In Anywhere

As stated, amoxicillin is not a recommended therapy for chlamydia infections.

This is because several studies have reported that penicillin-family antibiotics may not effectively eradicate a chlamydia infection, which may then persist after a course of antibiotics is completed .

Azithromycin is still the preferred treatment during pregnancy.

However, the CDC states that amoxicillin is an option for pregnant women since doxycycline is contraindicated during the second and third trimester and quinolone antibiotics may cause cartilage damage in infants.

If amoxicillin is used in a pregnant woman, the dose recommendation is as follows:

  • Amoxicillin 500 mg three times a day for 7 days

Recommendations for the treatment of chlamydia in pregnant women is summarized below in a chart provided by the CDC:

Is Doxycycline For Chlamydia Safe

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Doxycycline is safe to take provided that you are not over 15 weeks pregnant, you do not have any existing medical conditions, you are not taking any other medicines and you are over 12 years old. You should talk with your doctor before taking this medicine if you have diabetes or any disease or disorder affecting your kidneys or liver. Diabetes, Stevens-Johnson syndrome , systemic lupus erythematosus , kidney and liver problems may be exasperated if you take doxycycline. This antibiotic may be naturally removed from your body and processed by the liver and kidneys. If your kidney or liver function is impaired, doxycycline may on rare occasions build up and cause toxicity. You should therefore consult your doctor before taking this medication if you suffer from diabetes, systemic lupus erythematosus, myasthenia gravis or any disease or disorder of the kidney or liver.

Rarely, you may be allergic to this medicine and commonly you may experience some side effects when taking Doxycycline .

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Can You Drink Alcohol While Taking Azithromycin For Chlamydia

Yes, you may drink a small amount of alcohol while you are taking azithromycin but there is a chance large amounts of alcohol may increase the gastrointestinal side effects of azithromycin, such as nausea, diarrhea, vomiting, abdominal pain, dyspepsia, or flatulence. Too much alcohol with azithromycin may also give you a headache.

Because azithromycin is usually taken as a one-off dose, drinking alcohol is unlikely to stop azithromycin from curing chlamydia.

Data Collection And Measures

All data were obtained as part of routine medical care and recorded in the clinic’s electronic database. Clinicians used standardized instruments to record information about patient symptoms, concurrent STIs, and physical exam findings. Until October 2010, information on patient demographics , behavior , and STD history , were also collected by clinicians on standardized forms thereafter, these data were routinely obtained from English-speaking patients using a computer-assisted self-interview.

Throughout the study period, clinic protocol was to obtain rectal specimens from all male patients who reported receptive anal sex in the prior year. Between 1993 and September 2010, the clinic tested rectal specimens for chlamydia using McCoy cell culture14. Beginning in October 2010, the clinic tested all rectal specimens using nucleic acid amplification testing .

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What Do I Need To Know If I Get Treated For Chlamydia

If youre getting treated for chlamydia:

  • Take all of your medicine the way your nurse or doctor tells you to, even if any symptoms you may be having go away sooner. The infection stays in your body until you finish the antibiotics.
  • Your partner should also get treated for chlamydia so you dont re-infect each other or anyone else.
  • Dont have sex for 7 days. If you only have 1 dose of medication, wait for 7 days after you take it before having sex. If youre taking medicine for 7 days, dont have sex until youve finished all of your pills.
  • Get tested again in 3-4 months to make sure your infection is gone.
  • Dont share your medicine with anyone. Your nurse or doctor may give you a separate dose of antibiotics for your partner. Make sure you both take all of the medicine you get.
  • Even if you finish your treatment and the chlamydia is totally gone, its possible to get a new chlamydia infection again if youre exposed in the future. Chlamydia isnt a one-time-only deal. So use condoms and get tested regularly.

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Doxycycline Resistance And C Trachomatis

Chlamydia treatment in 100 seconds

Despite the absence of recent MIC data for C. trachomatis, low values of MICs of doxycycline were reported in the literature with MIC90 usually0.125 mg/L.,, Interestingly, doxycycline minimum chlamydiacidal concentrations varied according to the clinical presentation and the bacterial serovar, with lower MCCs in cases of asymptomatic infection than in mucopurulent cervicitis and pelvic inflammatory disease, and the highest MCCs observed for serovar Ia and J in mucopurulent cervicitis and pelvic inflammatory disease. In contrast, no MIC or MCC difference was observed between isolates recovered in the case of treatment failure or persistence compared with single-episode isolates. From these data and treatment success rates, pathogen resistance is expected to be low. However, tetracycline- and doxycycline-resistant isolates and isolates resistant to multiple antibiotics have been reported, some of thembut not allbeing involved in relapsing or persistent infection.

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What About Side Effects

Doxycycline is generally safe and well-tolerated. This is true even when it is used for long periods of time, as is the case when it is used to treat acne and as malarial prophylaxis. The most common side effects are gastrointestinal, such as diarrhoea, vomiting and nausea. Increased sensitivity to light can also be a concern with prolonged use. Side effects resolve once doxycycline is discontinued.

There is also concern regarding how ongoing antibiotic use affects the gut microbiome, including the impact on good bacteria and overall health. In the French study mentioned above, only eight of 232 men discontinued doxycycline due to gastrointestinal side effects. The two most common formulations are monohydrate and hyclate, with monohydrate generally better tolerated.

Urogenital Infection In Men

In men, chlamydial infection of the lower genital tract causes urethritis and, on occasion, epididymitis. Urethritis is secondary to C. trachomatis infection in approximately 15 to 55 percent of men, although the prevalence is lower among older men.2 Symptoms, if present, include a mild to moderate, clear to white urethral discharge. This is best observed in the morning, before the patient voids. To observe the discharge, the penis may need to be milked by applying pressure from the base of the penis to the glans.

The diagnosis of nongonococcal urethritis can be confirmed by the presence of a mucopurulent discharge from the penis, a Gram stain of the discharge with more than five white blood cells per oil-immersion field, and no intracellular gram-negative diplococci.2 A positive result on a leukocyte esterase test of first-void urine or a microscopic examination of first-void urine showing 10 or more white blood cells per high-powered field also confirms the diagnosis of urethritis.

For diagnosis of C. trachomatis infection in men with suspected urethritis, the nucleic acid amplification technique to detect chlamydial and gonococcal infections is best .4 Empiric treatment should be considered for patients who are at high risk of being lost to follow-up.

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Getting Treated For Chlamydia And Often Gonorrhea

If you have your own doctor, he will prescribe the antibiotics you need to treat chlamydia. If you dont have your own doctor, you can often find free or low-cost care at either a Planned Parenthood site or a community health clinic.

Listen carefully to the instructions for taking the medicine that you are given by the doctor or other healthcare provider, and follow them closely.

Ask questions if you dont understand something. Also, if you have other questions as you take your medicine, you can always call the pharmacist for help. They are often easier to reach than the doctor.

If you test positive for chlamydia, your healthcare provider is likely to also recommend that you be treated for gonorrhea. This is because the cost of treating gonorrhea is less than the cost of testing for the infection.

In men, chlamydial infection of the lower genital tract causes urethritis and, on occasion, epididymitis. Urethritis is secondary to C. trachomatis infection in approximately 15 to 55 percent of men, although the prevalence is lower among older men.2 Symptoms, if present, include a mild to moderate, clear to white urethral discharge. This is best observed in the morning, before the patient voids. To observe the discharge, the penis may need to be milked by applying pressure from the base of the penis to the glans.

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