2015 European guideline on the management of Chlamydia trachomatis infections

Abstract

Chlamydia trachomatis infections, which most frequently are asymptomatic, are major public health concerns globally. The 2015 European C. trachomatis guideline provides: up-to-date guidance regarding broader indications for testing and treatment of C. trachomatis infections; a clearer recommendation of using exclusively-validated nucleic acid amplification tests for diagnosis; advice on (repeated) C. trachomatis testing; the recommendation of increased testing to reduce the incidence of pelvic inflammatory disease and prevent exposure to infection; and recommendations to identify, verify and report C. trachomatis variants. Improvement of access to testing, test performance, diagnostics, antimicrobial treatment and follow-up of C. trachomatis patients are crucial to control its spread. For detailed background, evidence base and discussions, see the background review for the present 2015 European guideline on the management of Chlamydia trachomatis infections (Lanjouw E, et al. Int J STD AIDS. 2015).

Pharmacokinetics of a single 1g dose of azithromycin in rectal tissue in men

“…[4] However, with repeat rectal chlamydia rates of up to 22% reported following treatment with 1g azithromycin, [5] there is increasing concern about azithromycin treatment failure to the extent that both the European [6] and Australian [7] guidelines now recommend rectal infections be treated with seven days of doxycycline as the first line treatment.…”

Treatment of chlamydia and gonorrhoea, compliance with treatment guidelines and factors associatedwith non-compliant prescribing: findings form a cross-sectional study

“…To assess compliance of STI treatment with the guidelines, the antibiotic and amount prescribed were compared with integrated recommendations from the European guideline on the diagnosis and treatment of gonorrhoea in adults11 the European guideline for the management of Chlamydia trachomatis infections12 and the Estonian guideline for STI treatment13 (see online supplementary appendices 1 and 2). …”

Screening forChlamydia trachomatisandMycoplasma genitalium; is first void urine or genital swab best?

“…In women the vulvovaginal swab has been established as the sample of choice for Chlamydia trachomatis 1 2. However, there is no consensus on the optimal sample for the detection of Mycoplasma genitalium 3–6…”

“…Following the publication of international guidelines recommending the vulvovaginal swab for C. trachomatis screening,1 we discontinued dual collection of first void urine (FVU) and genital swab in women in 2010 and continued with only the genital swab. However, the subsequent publication of Gesink et al’s 6 study where 5 of 18 women (28%) tested positive for M. genitalium only in the urine sample and not the genital swab, prompted us to review our practice.…”