Patients were interviewed by telephone approximately days following therapy to assess compliance and side effects. Test of cure was performed at a follow-up visit weeks following completion of therapy.
Results: Thirty-nine patients were randomized with 19 receiving amoxicillin and 20 receiving azithromycin. The mucocutaneous lesions are papulosquamous eruptions that tend to occur on the palms of the hands and the soles of the feet.
The initial episode usually lasts for three to four months, but in rare cases the synovitis may last about one year. The treatment of C. Treatment also differs during pregnancy. For uncomplicated genitourinary chlamydial infection, the CDC recommends 1 g azithromycin Zithromax orally in a single dose, or mg doxycycline Vibramycin orally twice per day for seven days Table 1. If patients vomit the dose of azithromycin within one to two hours of taking the medication, an alternative treatment should be considered Table 1.
Information from reference 2. Follow-up of patients with urethritis is necessary only if symptoms persist or recur after completion of the antibiotic course. If symptoms suggest recurrent or persistent urethritis, the CDC recommends treatment with 2 g metronidazole Flagyl orally in a single dose plus mg erythromycin base orally four times per day for seven days, or mg erythromycin ethylsuccinate orally four times per day for seven days.
Patients should be advised to abstain from sexual intercourse for seven days after treatment initiation. In addition, physicians should obtain exposure information for the preceding 60 days and consider screening for other STDs such as human immunodeficiency virus HIV.
The CDC does not recommend repeat testing for chlamydia after completion of the antibiotic course unless the patient has persistent symptoms or is pregnant. Women who present within 12 months after the initial infection and have not been screened should be reassessed for infection regardless of whether the patient believes her sex partner was treated or not. PID usually can be treated on an outpatient basis. Hospitalization is required if a patient is pregnant; has severe illness, nausea and vomiting, or high fever; has tuboovarian abscess; is unable to follow or tolerate the outpatient oral regimen; or has disease that has been unresponsive to oral therapy.
Hospitalization also is indicated if surgical emergencies cannot be excluded. Ofloxacin Floxin mg orally twice daily for 14 days or levofloxacin Levaquin mg orally once daily for 14 days; with or without metronidazole Flagyl mg orally twice daily for 14 days. Ceftriaxone Rocephin mg IM in a single dose or cefoxitin Mefoxin 2 g IM in a single dose with concurrent probenecid Benemid 1 g orally in single dose or other parenteral third-generation cephalosporin; plus doxycycline Vibramycin mg orally twice daily for 14 days with or without metronidazole mg orally twice daily for 14 days.
Ofloxacin mg IV every 12 hours or levofloxacin mg IV once daily; with or without metronidazole mg IV every eight hours. Doxycycline and ofloxacin Floxin are contraindicated during pregnancy; therefore, the CDC recommends erythromycin base or amoxicillin for the treatment of chlamydial infection in pregnant women Table 3. Testing for cure is indicated in patients who are pregnant and should be performed three weeks after completion of treatment.
Exposure to C. Ophthalmia neonatorum usually occurs within five to 12 days of birth but can develop at any time up to one month of age. Prophylaxis with silver nitrate or antimicrobial ointment, which reduces the risk of gonococcal infection in neonates, does not reduce the risk of chlamydial infection.
Testing for chlamydial infection in neonates can be by culture or nonculture techniques. The eyelid should be everted and the sample obtained from the inner aspect of the eyelid.
Sampling the exudates is not adequate because this technique increases the risk of a false-negative test. Ophthalmia neonatorum can be treated with erythromycin base or ethylsuccinate at a dosage of 50 mg per kg per day orally, divided into four doses per day for 14 days.
Topical treatment is ineffective for ophthalmia neonatorum and should not be used even in conjunction with systemic treatment. Symptoms of chlamydial pneumonia typically have a protracted onset and include a staccato cough, usually without wheezing or temperature elevation.
Testing can be performed on a sample obtained from the nasopharynx. Nonculture techniques may be used, but they are less sensitive and specific for nasopharyngeal specimens than for ocular specimens.
If tracheal aspirates or lung biopsies are being collected for pneumonia in infants one to three months of age, the samples should be tested for C.
Like ophthalmia neonatorium, pneumonia secondary to C. Identification of asymptomatic infected persons and of symptomatic persons unlikely to seek diagnostic and treatment services. Evaluation, treatment, and counseling of sex partners of persons infected with an STD. STD prevention messages should be individually tailored and based on stages of patient development and understanding of sexual issues; these messages should be delivered nonjudgmentally.
Performing counseling and discussing behavioral interventions have been shown to reduce the likelihood of STDs and reduce risky sexual behavior. The CDC recommends annual screening for chlamydial infection in all sexually active women 24 years and younger and in women older than 24 years who are at risk of STDs e. Already a member or subscriber? Log in. Interested in AAFP membership? Untreated chlamydia can lead to serious complications, including pregnancy problems. If you are diagnosed with chlamydia, tell any sex partners from the past 60 days to go to the doctor for chlamydia testing and possible treatment.
A seven-day course of doxycycline taken twice daily is another option for people who are not pregnant. Each is highly effective in treating chlamydia infection. Other commonly prescribed antibiotics for chlamydia include erythromycin, levofloxacin, ofloxacin, and amoxicillin. These chlamydia medicines are taken for seven or 14 days. You need to take all of your medicine to cure chlamydia.
Your sex partner should be tested and treated, too. Newborns with eye infections due to chlamydia may be prescribed oral erythromycin or azithromycin.
To get our top stories delivered to your inbox, sign up for the Health Hookup newsletter. Chlamydia is easily cured with antibiotics. The sooner you get tested and treated, the quicker it goes away.
The longer chlamydia is left untreated, the greater the risk for serious complications. Women can develop pelvic inflammatory disease, a complication that causes scarring of the fallopian tubes. It can lead to fertility problems and chronic pelvic pain. Chlamydia infection during pregnancy can complicate pregnancy, sometimes leading to tubal pregnancy and preterm delivery. Chlamydia cannot kill you, but in some cases, tubal pregnancies, called ectopic pregnancies, can be fatal.
Chlamydia infection can also be passed to the newborn during delivery. People can have chlamydia more than once, and that can boost the risk for complications. If you have untreated chlamydia, you can pass it on to others without knowing it. To protect yourself and your sex partners, use condoms and consider limiting the number of people you have sex with. If you test positive for chlamydia, tell your current and former partners from the past 60 days so that they can get tested and treated, too.
What Is Chlamydia? Page last reviewed: 01 September Next review due: 01 September The two most commonly prescribed antibiotics for chlamydia are: doxycycline — taken every day for a week azithromycin — one dose of 1g, followed by mg once a day for 2 days Your doctor may give you different antibiotics, such as amoxicillin or erythromycin , if you have an allergy or are pregnant or breastfeeding.
When can I have sex again? Will I need to go back to the clinic? However, you will be advised to go back for another chlamydia test if: you had sex before you and your partner finished treatment you forgot to take your medication or didn't take it properly your symptoms don't go away you're pregnant If you're under 25 years of age, you should be offered a repeat test for chlamydia 3 to 6 months after finishing your treatment because you're at a higher risk of catching it again.
Testing and treating sexual partners If you test positive for chlamydia, it's important that your current sexual partner and any other recent sexual partners you've had are also tested and treated.
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