Chlamydia Reinfection: Risk, Prevention, and Retesting Guidelines

Chlamydia trachomatis reinfection is common—up to 20% within a year—mostly from untreated partners or new exposures. Prior infection confers no immunity.

Key Points

• Treatment: Azithromycin 1 g single dose or doxycycline 100 mg BID × 7 days. Abstain 7 days after treatment (both partners).
• Reinfection ≠ treatment failure: If partners untreated, re-exposure occurs.
• Retesting: CDC recommends retest at 3 months for all treated persons, regardless of partner treatment.
• Expedited partner therapy (EPT): Providing medication to partners without clinical evaluation (legal in many states).

Symptoms (Often Asymptomatic)

• Urethritis/cervicitis: discharge, dysuria
• PID (women): abdominal pain, fever, cervical motion tenderness
• Proctitis (receptive anal): rectal pain, discharge
• Conjunctivitis (ocular exposure)

Complications of Repeat Infections

• Increased risk of PID, tubal infertility, ectopic pregnancy, chronic pelvic pain.
• Epididymitis in men.
• Enhanced HIV susceptibility.

Prevention

• Condoms consistently.
• Mutual monogamy with tested partner.
• Regular screening (annually for sexually active women <25, MSM, high-risk).
• Notify all partners from past 60 days.