Chlamydia Treatment: Antibiotics, Adherence, Retesting, and Partner Notification

Recommended Regimens (CDC 2021)

• Azithromycin 1 g PO single dose — preferred for adherence.
• Doxycycline 100 mg PO BID × 7 days — slightly higher efficacy; avoid in pregnancy.
• Alternative: Levofloxacin 500 mg PO daily × 7 days.

Keys to Cure

• Complete the full course — do not stop early.
• Abstain from sex until 7 days after single-dose azithromycin or until completion of doxycycline AND partners treated.
• Partner notification and treatment essential to prevent reinfection (expedited partner therapy available in many states).
• Test of cure: NAAT at 3-4 weeks if pregnant, symptoms persist, or adherence uncertain. Routine retest at 3 months for all (high reinfection rate).

Complications of Untreated Chlamydia

• Women: PID, tubal infertility, ectopic pregnancy, chronic pelvic pain.
• Men: Epididymitis, prostatitis, reactive arthritis.
• Neonatal: Ophthalmia neonatorum, pneumonia.

Prevention

• Consistent condom use.
• Regular screening (annually for sexually active women <25, MSM, high-risk).
• Mutual monogamy with tested partner.