Chlamydia Trachomatis/Urethritis
NHSL Antimicrobial Guidelines
If positive for chlamydia, treat index case, refer to GUM to initiate partner notification, testing and treatment.
Advise patient with chlamydia to abstain from sexual intercourse until doxycycline is completed or for 7 days after treatment with azithromycin (If urethritis -14 days after treatment started and until symptoms resolved).
Test of cure (TOC) not routinely recommended following completion of treatment unless: pregnant; rectal infection; poor compliance with treatment; lymphogranuloma venereum (LGV). Perform TOC no sooner than 3 weeks (DNA may be detected by NAAT for 3-5 weeks following treatment). Alternatively, where LGV is suspected (higher risk in HIV positive individuals, proctitis) consider treating with three weeks of doxycycline.
Test for re-infection at 3-6 months following treatment if <25 years; or consider if >25 years and high risk of re-infection.
Drug details
Drug
First line:
Doxycycline
Dosage
100mg
Duration
twice daily for 7 days
Drug
Alternative required (pregnant or breastfeeding): Azithromycin
Dosage
1g
500mg
Duration
single dose then
once daily 2 days (total 3 days)