Test of Cure for Chlamydia and Gonorrhea
Test of cure is NOT routinely recommended for uncomplicated chlamydia and gonorrhea infections when patients receive recommended treatment regimens and symptoms resolve. 1, 2
When Test of Cure is NOT Indicated
- Uncomplicated infections treated with recommended regimens (ceftriaxone for gonorrhea, doxycycline or azithromycin for chlamydia) do not require test of cure if symptoms resolve 1, 2
- Patients who received appropriate treatment and are asymptomatic should not undergo repeat testing at 3-4 weeks post-treatment 1
When Test of Cure IS Indicated
Pregnant patients are the primary exception and require mandatory test of cure:
- Perform test of cure 4 weeks after treatment completion in all pregnant patients diagnosed with chlamydia or gonorrhea 3, 4
- This is critical because pregnancy complications necessitate confirmation of cure 3
Other specific situations requiring test of cure:
- Persistent symptoms after completing therapy warrant retesting 1
- Suspected treatment failure for gonorrhea requires culture and antimicrobial susceptibility testing 2, 5
- Therapeutic noncompliance or suspected reinfection from untreated partners 1
Reinfection Testing (Different from Test of Cure)
All patients should be retested approximately 3 months after treatment regardless of whether they believe partners were treated:
- This is for reinfection detection, not test of cure 1, 6, 2
- High reinfection rates (documented in multiple studies) justify this universal recommendation 1, 6
- Acceptable timeframe is 3-6 months post-treatment or at first clinical visit within 12 months 1, 6
Common Pitfalls to Avoid
- Do not confuse test of cure (3-4 weeks) with reinfection screening (3 months) - these serve different purposes 1, 6
- Do not perform routine test of cure in non-pregnant patients with uncomplicated infections - this wastes resources and is not evidence-based 1, 2
- Do not use symptoms alone as basis for retreatment without objective laboratory or clinical evidence of urethral/cervical inflammation 1
- Do not skip the 3-month reinfection screening - this is where the real clinical benefit lies given high reinfection rates 1, 6