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Treatment[edit]
Treatment depends on the infection site, age of the patient, and whether another infection is present. Having a C. trachomatis and one or more other sexually transmitted infections at the same time is possible. Treatment is often done with both partners simultaneously to prevent reinfection. C. trachomatis may be treated with several antibiotic medications, including azithromycin, erythromycin, or ofloxacin.[9]
Azithromycin and doxycycline have equal efficacy to treat C. trachomatis with 97 and 98 percent success, respectively. Azithromycin is dosed as a 1 gram tablet that is taken by mouth as a single dose, primarily to help with concerns of non-adherence.[1] Treatment with generic doxycycline 100 mg twice a day for 7 days has equal success with expensive delayed-released doxycycline 200 mg once a day for 7 days.[14] Erythromycin is less preferred as it may cause gastrointestinal side effects, which can lead to non-adherence. Levofloxacin and ofloxacin are generally no better than azithromycin or doxycycline and are more expensive.[1]
If treatment is necessary during pregnancy, levofloxacin, ofloxacin, and doxycycline are not prescribed. In the case of a patient who is pregnant, the medications typically prescribed are azithromycin, amoxicillin, and erythromycin. Azithromycin is the recommended medication and is taken as a 1 gram tablet and taken by mouth as a single dose. [1] Despite amoxicillin having fewer side effects than the other medications for treating antenatal C. trachomatis infection, there have been concerns that pregnant women who take penicillin-class antibiotics can develop persistence to chlamydia. [1] Retesting during pregnancy can be performed three weeks after treatment. If the risk of reinfection is high, screening can be repeated throughout pregnancy.[9]
If the infection has progressed, ascending the reproductive tract and pelvic inflammatory disease develops, damage to the fallopian tubes may have already occurred. In most cases, the C. trachomatis infection is then treated on an outpatient basis with azithromycin or doxycycline. Treating the mother of an infant with C. trachomatis of the eye, which can evolve into a pneumonia, is recommended.[9] The recommended treatment consists of oral Erythromycin base or ethylsuccinate 50 mg/kg/day divided into 4 doses daily for two weeks while monitoring for symptoms of infantile hypertrophic pyloric stenosis (IHPS) in infants less than 6 weeks old.[1]
Early signs of neonatal infections may be asymptomatic but include
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