Guidelines

Investigation and Diagnosis

Screening

According to the National Chlamydia Screening Programme (NCSP), the following should be offered a chlamydia test:

• Partner with chlamydia or symptoms of chlamydia infection
• All sexually active women <25 y/o (to be tested yearly and after having sex with a new partner)
• All sexually active women <25 y/o who attend a sexual health service / contraception service / termination of pregnancy service

Chlamydia Diagnosis

Test of choice: NAAT.

Sample collection methods:

• Male 1st line: first pass urine (alternative: urethral swab)
• Female 1st line: vulvovaginal swab (alternative: endocervical swab or first pass urine)

Management

Refer ALL patients to GUM clinic / local specialist for management.
 

General Advice

Abstain from all sexual activity until 7 days after they and their partner(s) have completed treatment

Pharmacological Management

1st line: oral doxycycline100mg BD for 7 days

2nd line: oral azithromycin 1g OD for 1 day followed by 500mg OD for 2 days

3rd line: oral erythromycin
 

Management in Pregnant Patients

• Discuss with GUM and specialist
• Options include: azithromycin, erythromycin, amoxicillin
• Test of cure is routinely needed in pregnant patients

Partner Notification

• If symptomatic men → notify all partners within the past 4 weeks (1 month) (or most recent partner if more than 4 weeks ago)

• If all other patients (i.e. asymptomatic men and women) → notify all partners within the past 6 months

Follow Up

Test of Cure

Test of cure is NOT routinely recommended.

Exceptions:

• Pregnant patients
• Poor compliance
• Persistent symptoms 

Test of cure should be performed at least 3 weeks after completion of treatment. 

Repeat Testing

Repeat testing indications:

• Offer to all <25 y/o diagnosed with chlamydia, 3-6 months after completion of treatment
• Consider if >25 y/o who are at high risk of re-infection

References

Original Guideline