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Chlamydia contents
Essential facts
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Diagnosis and
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Genital Chlamydia trachomatis Infection
Diagnosis and management
Diagnosis
Management
Epidemiologic treatment
Patient education
Follow-up
Diagnosis
is made on a positive urethral swab or first catch urine in males and on a
positive endocervical swab in females for chlamydia PCR.
In females without a cervix or in whom swabs cannot be taken, a
first catch urine can be tested for chlamydia PCR.
Serology
is of no value in the diagnosis of genital tract chlamydial infection.
Treatment
Standard
therapy
azithromycin
1 g orally as one dose (ADEC B1)
Patients
allergic to macrolides
doxycycline
200 mg orally daily for 10 days (ADEC D)
Epidemiologic
treatment is given to sexual partners, regardless of age or gender, of
persons with proven chlamydia.
In
all cases, appropriate investigations for chlamydia should be performed
before treatment is provided.
The
following points should be covered:
-
Chlamydia
is sexually transmitted
-
It
is common
-
Infection
is asymptomatic in up to 50% of men and 90% of women
-
Re–infection may occur during or after treatment
-
Abstinence
from sex until 1 week after patient and partner treatment
-
Chlamydia
is a notifiable disease
-
Advise
on the side effects of medications
-
Provide literature
on chlamydia.
Contact
tracing
Contact
tracing is required.
-
Test
of cure is not recommended with PCR
-
Check
on medication compliance if single dose therapy not used, reaction to
medication
-
Evaluate
symptoms and signs
-
Enquire
about further sexual activity since diagnosis, reinforce prevention
and safe sex practices
-
Confirm
contact tracing
-
Re-test
at 3 months for new infection
-
Serological
screening
for HIV, hepatitis B and syphilis in 3 months
Chlamydia
is
a notifiable
infection in South Australia.
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