From the Guidelines
Chlamydial cervicitis is a sexually transmitted infection caused by the bacterium Chlamydia trachomatis.
Cause and Risk Factors
Chlamydial cervicitis is primarily caused by sexual transmission of Chlamydia trachomatis, as stated in 1. Risk factors include:
- Multiple sexual partners
- Unprotected sex
- Young age
- A history of previous sexually transmitted infections
- Inconsistent condom use, and exchanging sex for money or drugs, as mentioned in 1
- Being African-American or Hispanic, as these groups have a higher prevalence of infection, according to 1
Preventive Measures
The use of condoms during sexual intercourse, limiting the number of sexual partners, and regular screening for sexually transmitted infections can help prevent chlamydial cervicitis, as recommended in 1.
Signs and Symptoms
Symptoms may include:
- Abnormal vaginal discharge
- Bleeding between menstrual periods
- Painful urination
- Abdominal pain However, many individuals with chlamydial cervicitis are asymptomatic, as stated in 1.
Treatment
The recommended treatment for chlamydial cervicitis is:
- A single dose of Azithromycin 1g orally, as recommended in 1
- Doxycycline 100mg orally twice a day for 7 days, as mentioned in 1 Alternative treatments include:
- Erythromycin base 500mg orally four times a day for 7 days
- Levofloxacin 500mg orally once daily for 7 days It is essential to complete the full treatment course and to have all sexual partners treated simultaneously to prevent reinfection, as stated in 1. Pregnant women should be treated with Azithromycin or Amoxicillin, according to 1.
Follow-up
A test of cure is recommended 3 months after treatment to ensure the infection has been cleared, as mentioned in 1.
From the Research
Cause of Chlamydial Cervicitis
- Chlamydia trachomatis is the most common cause of bacterial sexually transmitted infections (STI) worldwide, and it is a common cause of urethritis and cervicitis 2, 3.
- The bacterium can cause ascending infection in females, leading to pelvic inflammatory disease (PID), which can result in infertility and ectopic pregnancy 2, 4.
Risk Factors for Chlamydial Cervicitis
- The risk of chlamydial infection is higher in young women, with the highest prevalence found among non-Hispanic black females 4.
- Sexually active women aged <25 years are at increased risk of chlamydial infection, and routine screening is recommended for this population 4.
- Untreated chlamydial infection can lead to severe long-term consequences, including an increased risk of ectopic pregnancy, tubal infertility, and chronic pelvic pain 2, 5.
Preventive Measures for Chlamydial Cervicitis
- Screening for chlamydial infection is necessary to identify most infections, as they are usually asymptomatic 2, 4.
- Routine screening for young women and screening during pregnancy are recommended in several countries 5.
- Education and awareness campaigns are needed to inform health-care providers and the public about the importance of screening and prevention of chlamydial infection 5.
Signs and Symptoms of Chlamydial Cervicitis
- Chlamydial infections are usually asymptomatic, but some women may develop symptoms such as salpingitis, endometritis, pelvic inflammatory disease (PID), and ectopic pregnancy 3.
- The infection can cause minimal or no symptoms in approximately two-thirds of women, remaining clinically apparent and undiagnosed 5.
Treatment of Chlamydial Cervicitis
- Currently recommended treatment regimens include azithromycin in a single dose or doxycycline for 7 days, which are highly efficacious 2.
- Timely management of sex partners is essential for decreasing the risk for re-infection 2.
- Prompt treatment for infected persons and ensuring that infected patients' sex partners receive timely treatment are crucial to prevent the spread of the disease and severe sequelae 3, 4.