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Chlamydia, Antibiotic Prescribing

Safe Prescribing (visit the safe prescribing page)


Comments from Expert Advisory Committee

  1. Chlamydia, caused by Chlamydia trachomatis, is the commonest STI reported in Ireland with almost half of cases diagnosed in those aged between 15 and 24 years
  2. Frequently asymptomatic in both males and females. Symptoms in males include dysuria and a urethral discharge. Symptoms in women include vaginal discharge, intermenstrual bleeding, post coital bleeding
  3. Infection can lead to epididymo-orchitis in males.
  4. Can lead to pelvic inflammatory disease (PID) in females. PID is associated with an increased risk of tubal factor infertility, ectopic pregnancy and chronic pelvic pain
  5. Diagnosis using NAAT (nucleic acid amplification technique, eg PCR, polymerase chain reaction) is the current diagnostic gold standard. This is frequently combined with a gonorrhoea NAAT in the same test
  6. Diagnosis can be made on first void urine in males and vulvovaginal or endocervical swab in females. Vulvovaginal swabs can be provider or self-taken.
  7. In sexually active men who have sex with men (MSM), three site CT testing (first void urine, pharyngeal and rectal sites ) is recommended.
  8. Test of cure is not routinely required but is suggested in pregnancy and in women with an intrauterine device. If doing a test of cure, wait until at least 3 weeks post completion of treatment
  9. Individuals diagnosed with chlamydia should be offered testing for other STIs including HIV, Hepatitis B, syphilis and gonorrhoea.
  10. Hepatitis C testing should be considered part of routine sexual health screening in the following circumstances: People who are HIV positive; Commercial sex workers; PWID Patients who inject drugs ; If indicated by the clinical history e.g. unexplained jaundice; When other risk factors for HCV are present, for example MSM. The full set of recommendations around HCV testing are available in the national HCV screening guidelines.
  11. Sexual partners in the preceding 6 months should be informed of the need for testing and patients should be encouraged to inform their sexual partners
  12. Chlamydia is a notifiable disease. The complete list of notifiable diseases and information on the notification process is available from HPSC. http://www.hpsc.ie/NotifiableDiseases/

Treatment

Treatment of uncomplicated anogenital Chlamydia is outlined in the table below.

chlamydia treatment table 2019

Useful resources


Patient Information

Reviewed December 2019


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