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Chlamydia

Recommended Regimens
  • Azithromycin 1 g orally in a single dose
    OR
  • Doxycycline 100 mg orally twice a day for 7 days
Alternative Regimens
  • Erythromycin base 500 mg orally four times a day for 7 days
    OR
  • Erythromycin ethylsuccinate 800 mg orally four times a day for 7 days
    OR
  • Levofloxacin 500 mg orally once daily for 7 days
    OR
  • Ofloxacin 300 mg orally twice a day for 7 days

  • Organism: Obligate intracellular, gram negative bacerium, chalymdia trachomatis
  • Epidemiology:
    • It is the most common bacterial cause of STDs and the most commonly reported STD with 1.8 million cases in 2018, representing a 19% increase since 2014 (CDC)
  • Symptoms/Findings: Majority are asymptomatic
    • Cervicitis
    • Urethritis
    • Urinary frequency
    • Dysuria
    • Pelvic Inflammatory Disease (PID)
    • Vaginal discharge
    • Fitz-Hugh-Curtis syndrome – peritoneal inflammation, and perihepatitis
    • Epididymitis
    • Prostatitis
    • Proctitis
    • Conjunctivitis
    • Pharyngitis
  • Testing:
    • In women, the sensitivity of nucleic acid amplification testing (NAAT) on urine (92%) appears to be slightly lower than the sensitivity on vaginal samples (97%). Self-taken vulvovaginal swabs are as accurate as clinician-performed tests. In men, the diagnostic test of choice is NAAT of first-catch urine, with urethral swab as a secondary option. NAAT can also be performed on conjunctival swabs.

Source

CDC: Chlamydial Infections in Adolescents and Adults, 2015

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