From the Guidelines
The recommended treatment for Chlamydia is a course of antibiotics, typically doxycycline 100mg taken orally twice daily for 7 days, or azithromycin as a single 1-gram oral dose. For pregnant women, azithromycin is preferred as doxycycline is contraindicated during pregnancy. Alternative treatments include amoxicillin 500mg three times daily for 7 days or erythromycin if other options aren't suitable. It's crucial to complete the entire course of antibiotics even if symptoms improve before finishing.
Key Considerations
- Sexual partners should also be treated to prevent reinfection, and patients should abstain from sexual activity until both they and their partners complete treatment.
- A follow-up test is recommended 3-4 weeks after treatment to confirm the infection has cleared.
- Chlamydia responds well to antibiotics because the causative bacterium, Chlamydia trachomatis, is susceptible to these medications which work by preventing bacterial protein synthesis or cell wall formation, effectively eliminating the infection when taken as prescribed.
Treatment Guidelines
According to the Centers for Disease Control and Prevention (CDC) guidelines, as outlined in 1, the recommended treatment for chlamydia infection is 1 g of azithromycin in a single oral dose or with oral doxycycline, 100 mg twice daily for 7 days.
Patient Education
Patients should be instructed to abstain from sexual intercourse for 7 days after single-dose therapy or until completion of a 7-day regimen, as stated in 1 and 1. Additionally, patients should be instructed to abstain from sexual intercourse until all of their sex partners are treated to minimize the risk for reinfection.
Partner Referral
Patients should refer for evaluation and treatment all sex partners within the preceding 60 days, as recommended in 1. Because a specific diagnosis may facilitate partner referral, testing for gonorrhea and chlamydia is encouraged.
From the FDA Drug Label
Uncomplicated urethral, endocervical, or rectal infection in adults caused by Chlamydia trachomatis: 100 mg, by mouth, twice a day for 7 days. The recommended treatment for Chlamydia is doxycycline 100 mg, by mouth, twice a day for 7 days 2.
- The dose may be administered with food, including milk or carbonated beverage, as required.
- Doxycycline is the preferred treatment for uncomplicated Chlamydia infections.
From the Research
Chlamydia Treatment Options
- The recommended treatment for Chlamydia includes azithromycin and doxycycline, with the choice of antibiotic depending on the specific circumstances of the infection 3, 4, 5, 6, 7.
- A single 1-g dose of azithromycin is as effective as a standard seven-day course of doxycycline for the treatment of uncomplicated genital chlamydial infections 3.
- However, for rectal chlamydia, a 7-day course of doxycycline has been shown to be superior to single-dose azithromycin in terms of treatment efficacy 6.
- In women with concurrent vaginal and anorectal Chlamydia trachomatis infection, doxycycline has been found to have a higher microbiological anorectal cure rate compared to azithromycin 7.
Treatment Efficacy
- The efficacy of azithromycin and doxycycline can vary depending on the specific type of Chlamydia infection being treated, with doxycycline being more effective for rectal and anorectal infections 6, 7.
- Azithromycin has been shown to have a lower treatment efficacy for rectal chlamydia compared to doxycycline, with a microbiologic cure rate of 76.4% compared to 96.9% for doxycycline 6.
- The choice of antibiotic should be based on the specific circumstances of the infection, including the type of infection, patient factors, and potential side effects 3, 4, 5, 6, 7.
Side Effects and Adverse Events
- Both azithromycin and doxycycline can cause side effects, including gastrointestinal symptoms such as nausea, diarrhea, and vomiting 3, 6, 7.
- The incidence of adverse events can vary depending on the specific antibiotic and the population being treated, with azithromycin being associated with a higher rate of adverse events in some studies 6, 7.