CHLAMYDIA 

What is chlamydia?

Chlamydia is an infection by Chlamydia trachomatis that most often occurs in sexually active adolescents and young adults. It can cause urethritis and the resultant complicating infections of epididymitis and orchitis. Recent studies have suggested, however, that some people, both men and women, can be infected but have no symptoms. Thus, these individuals can unknowingly spread the infection to others. Consequently, sexually active individuals should be routinely evaluated for chlamydial urethritis. Note that another strain (type) of Chlamydia trachomatis, which can be distinguished in specialized laboratories, causes LGV.

How is chlamydia treated?

A single dose therapy is always advantageous because it assures that the patient takes the medication. The only such treatment for Chlamydia is azithromycin (Zithromax) 1 gram by mouth. Alternative treatments are often used, however, because of the high cost of this medication. Acceptable alternatives include doxycycline 100 mg twice per day for 7 days, erythromycin 500 mg four times per day for 7 days, or ofloxacin (Oflox) 300 mg twice per day for 7 days, all taken by mouth. Patients should be instructed to abstain from sex for 7 days after the start of treatment and to notify all of their sexual contacts. The contacts should also then be evaluated for chlamydial infection.

The most common reason for the recurrence of chlamydia infection is the failure of the partners of infected persons to receive treatment. The originally infected person then becomes reinfected from the untreated partner. Other reasons are the failure to correctly follow one of the 7-day treatment regimens or the use of erythromycin for treatment, which has been shown to be somewhat less effective than azithromycin or doxycycline. Complicated chlamydial infections, epidydimitis, and orchitis are generally treated with a standard single-dose therapy as used for Neisserie gonorrhea (described below) and 10 days of treatment for Chlamydia trachomatis with doxycycline. In this situation, a single dose therapy for chlamydia is not an option.

What should a person do if exposed to someone with chlamydia?

Persons who know that they have been exposed to someone with chlamydia should be evaluated for the symptoms of urethritis and tested for evidence of inflammation and infection. If infected, they should be treated appropriately. Many doctors recommend treating all individuals exposed to an infected person if the exposure was within the 60 days preceding the partner's diagnosis.