Chlamydia Treatment in Late Pregnancy (37 Weeks): Safe & Essential
Chlamydia trachomatis infection in pregnancy risks neonatal conjunctivitis, pneumonia, and preterm labor. Treatment at 37 weeks is safe and indicated.
Recommended Regimens (CDC 2021)
- Azithromycin 1 g PO single dose – preferred (category B, extensive safety data).
- Amoxicillin 500 mg PO TID × 7 days – alternative (category B).
- Erythromycin base 500 mg QID × 7 days – GI side effects limit use.
- Avoid doxycycline (tetracycline class) – contraindicated in pregnancy (fetal teeth/bone).
Partner Management
- Expedited partner therapy (EPT) where legal.
- Test‑of‑cure at 3–4 weeks (NAAT) due to higher failure in pregnancy.
Neonatal Prophylaxis
Erythromycin 0.5% ophthalmic ointment at birth prevents chlamydial ophthalmia (mandatory in most US states).
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