infectious diseases
Chlamydia and Mycoplasmal Mucosal Infections
Treatment of Chlamydia
Oral antibiotics (preferablyazithromycin) Empiric treatment for gonorrhea if it has not been excluded Treatment of sex partners Uncomplicated documented or suspected chlamydial infections are treated with one of the following: A single dose ofazithromycin1 g orally Doxycycline100 mg orally twice a day for 7 days Levofloxacin500 mg orally once a day for 7 days may be preferable for rectal chlamydia ( Treatment references ). For pregnant women,azithromycin1 g orally once should be used.Amoxicillin500 mg orally 3 times a day for 7 days is an alternative therapy for pregnant women. Pregnant women should have a test of cure 4 weeks after treatment and be retested within 3 months. resistance ( Treatment references ). If there is known These regimens do not reliably treat gonorrhea, which coexists in many patients with chlamydial infections. Therefore, treatment should include a single dose ofceftriaxone500 mg IM (1 g IM for patients weighing ≥ 150 kg) if gonorrhea has not been excluded. Patients who relapse (about 10%) are usually coinfected with microbes that do not respond to antichlamydial therapy, or they were reinfected since treatment. They should be retested for chlamydial infection and gonorrhea and, if possible, for mycoplasma and trichomoniasis. In areas where Trichomoniasis is prevalent, empiric treatment with Current sex partners should be treated. Patients should abstain from sexual intercourse until they and their partners have been treated for ≥ 1 week. If chlamydial genital infections are untreated, symptoms and signs subside within 4 weeks in about two thirds of patients. However, in women, asymptomatic cervical infection may persist, resulting in chronic endometritis, salpingitis, or pelvic peritonitis and their sequelae—pelvic pain, infertility, and increased risk of ectopic pregnancy. Because chlamydial infections can have serious long-term consequences for women, even when symptoms are mild or absent, detecting the infection in women and treating them and their sex partners is crucial. 1.Kong FYS, Tabrizi SN, Fairley CK, et al: The efficacy ofazithromycinanddoxycyclinefor the treatment of rectal chlamydia infection: a systematic review and meta-analysis.J Antimicrob Chemother70: 1290–1297, 2015. doi: 10.1093/jac/dku574 2.Centers for Disease Control and Prevention: Sexually Transmitted Infections Treatment Guidelines, 2021:Mycoplasma genitalium. Accessed June 27, 2022. 