Which treatment for genital tract Chlamydia trachomatis infection?

Abstract

A national opportunistic chlamydia screening programme, mainly targeting young sexually active women, is gradually being introduced across the UK and in future will predominantly occur in primary care sites. The relative efficacy of recommended antibiotic treatments for chlamydia has been poorly studied and especially that of single dose azithromycin. In Portsmouth, 1536 patients treated for chlamydia, with four different antibiotic regimens, during the Department of Health pilot study, were asked to return for test of cure. No difference in treatment outcome was found using doxycycline, oxytetracycline, erythromycin or azithromycin. Directly observed therapy with azithromycin may be especially helpful in treating young chlamydia-positive patients.

Screening and treatment of Chlamydia trachomatis infections

“…A single dose of azithromycin (1 g orally) is highly effective-more than 95% of those treated are negative for chlamydia after two weeks. 22 The single dose option increases compliance. Advise patients to avoid sexual contact during treatment and for seven days afterwards to prevent reinfection before the treatment has been effective.…”

Re-infection of Chlamydia trachomatis in patients presenting to the genitourinary medicine clinic in Portsmouth: the chlamydia screening pilot study — three years on

“…They had received treatment of a one-week course of doxycycline (100 mg twice a day), a 10-day course of erythromycin (500 mg twice a day), a 10-day course of oxytetracycline (500 mg twice a day), or a single dose of azithromycin (1 g). Follow-up test of cure by urine ligase chain reaction (LCR) showed no difference in cure rates between different regimens 18 .…”

“…Previous studies have reported highest rates in the under 25-year old age group 12,13 . The Department of Health (DoH) set up an opportunistic screening programme for genital chlamydia infection, focusing on sexually active [16][17][18][19][20][21][22][23][24] year old women (F) attending predominately primary care settings, genitourinary medicine (GUM), family planning and youth clinics in Portsmouth and Wirral 14,15 . Men in the same age group attending GUM and youth clinics were also offered screening.…”

Opportunistic chlamydia screening in a general practice consultation

“…An infection with chlamydia can occur at any age but is most common in people under the age of 25, 1 with rates of diagnosis peaking in women aged [16][17][18][19] and men aged 20-24. 2 …”

“…A single dose of azithromycin (1 g orally) is highly effective-more than 95% of those treated are negative for chlamydia after four weeks. 16 Test of cure is not needed if treatment has been taken correctly and partners have been treated too. However re-testing three to four months after treatment is recommended because of the high rates of reinfection 2 ).…”