From the Guidelines
A test of cure is not necessary for most sexually transmitted infections (STIs) after completion of treatment, unless symptoms persist or reinfection is suspected. For gonorrhea, a test of cure is not recommended unless symptoms persist or therapeutic noncompliance or reinfection is suspected 1. For chlamydia, a test of cure is not necessary after completion of treatment with azithromycin or doxycycline, unless symptoms persist or reinfection is suspected 1. However, rescreening for chlamydia 3 to 4 months after treatment is recommended, especially in adolescents and young adults 1.
Key Considerations
- The need for test of cure varies based on the specific pathogen, treatment efficacy, risk of complications, and public health implications.
- When required, test of cure typically involves repeating the diagnostic test (NAAT for gonorrhea/chlamydia, serologic tests for syphilis) after an appropriate interval following treatment completion to ensure the infection has been successfully eliminated.
- For pregnant women, a test of cure to document eradication of chlamydial infection 3 weeks after treatment is recommended 1.
- Repeat testing of all patients diagnosed with chlamydia or gonorrhea is recommended 3-6 months after treatment, regardless of whether patients believe their partners have been treated 1.
Recommendations
- Do not perform routine test of cure for gonorrhea or chlamydia after completion of treatment, unless symptoms persist or reinfection is suspected.
- Rescreen for chlamydia 3 to 4 months after treatment, especially in adolescents and young adults.
- Perform test of cure for pregnant women with chlamydial infection 3 weeks after treatment.
- Repeat testing for all patients diagnosed with chlamydia or gonorrhea 3-6 months after treatment, regardless of whether patients believe their partners have been treated.
From the Research
Test of Cure in STI Treatment
- The test of cure is an important aspect of STI treatment, as it helps to determine whether the infection has been successfully eradicated 2.
- According to a study published in the Lancet, a test of cure is recommended 4-8 days after treatment for uncomplicated urogenital gonorrhea to ensure that the infection has been cured 2.
- The Centers for Disease Control and Prevention (CDC) also recommend a test of cure for certain STIs, such as gonorrhea, to ensure that the infection has been successfully treated 3.
- However, the frequency and timing of test of cure may vary depending on the specific STI and treatment regimen, and should be guided by clinical practice guidelines and expert recommendations 4.
Importance of Test of Cure
- A test of cure is essential to prevent the spread of antibiotic-resistant strains of STIs, such as gonorrhea 3.
- It also helps to identify treatment failures and ensure that patients receive effective treatment 2.
- Furthermore, a test of cure can help to reduce the risk of complications and long-term sequelae associated with untreated STIs 5.
Challenges and Limitations
- One of the challenges in implementing test of cure is ensuring that patients return for follow-up testing, which can be a barrier to effective treatment 5.
- Additionally, the availability and accessibility of testing services can be limited in some settings, making it difficult to implement test of cure 6.
- Further research is needed to develop effective strategies for implementing test of cure and improving treatment outcomes for STIs 4.