Chlamydia – Diagnosis and Treatment
Diagnosis
Chlamydia is a common sexually transmitted infection (STI). It often does not cause symptoms, so testing helps find cases early.
Many people with chlamydia do not realize they have it because they may feel fine. Untreated infection can lead to serious health problems, such as pelvic inflammatory disease (PID), infertility, ectopic pregnancy, and a higher risk of HIV or other infections.
Who Should Get Tested?
Certain groups need regular chlamydia screening.
- Sexually Active Women Under 25 Years Old: They have the highest rates of chlamydia and should get tested each year.
- Pregnant Women: They should get tested at the first prenatal visit and sometimes again later if at higher risk.
- High-Risk Groups: This includes anyone with new or multiple sexual partners, men who have sex with men, or those with another STI.
People who have symptoms like abnormal vaginal discharge, penile discharge, burning while urinating, rectal pain, or unexplained bleeding should talk to a healthcare provider about chlamydia testing.
How Healthcare Providers Detect Chlamydia
Healthcare professionals use several methods to check for chlamydia.
| Test Type | Who Itโs For | How Itโs Done |
|---|---|---|
| Urine test | Males and females | Person gives a urine sample. |
| Swab (cervix) | People with a cervix | Provider collects a sample from the cervix. |
| Swab (vagina) | People with a vagina | A swab is collected by self or provider. |
| Swab (rectum) | Anyone with anal exposure | Swab taken from the rectum. |
| Swab (throat) | With oral STI risk | Swab taken from the throat. |
Most clinics use nucleic acid amplification tests (NAATs). These tests are very accurate for finding Chlamydia trachomatis.
Labs usually perform these tests, but sometimes clinics use rapid point-of-care tests.
Screening and Self-Testing Options
People can use at-home test kits to collect their own urine or swab samples. They send the samples to a lab for analysis.
A healthcare provider should confirm positive results from these kits before starting treatment.
Testing in Special Cases
Screening is especially important for those at higher risk, including young women and pregnant people.
People who had chlamydia before or have other STIs like gonorrhea should get tested regularly to catch reinfections early.
Treatment
Doctors usually treat chlamydia with antibiotics. Two common options are tetracycline-class antibiotics and macrolide antibiotics.
A tetracycline-class antibiotic is typically taken at a dose of 100 mg by mouth twice daily for 7 days. A macrolide antibiotic may sometimes be given as a single, one-time oral dose of 1 gram.
| Medication | Dose | Duration |
|---|---|---|
| Tetracycline-class antibiotic | 100 mg, oral, twice daily | 7 days |
| Macrolide antibiotic | 1 gram, oral | 1 dose |
| Fluoroquinolone antibiotic* | 500 mg, oral, once daily | 7 days |
*Fluoroquinolone antibiotics are used in some cases when standard antibiotics are not suitable.
Patients should not have sex until they and any sexual partners finish treatment and symptoms are gone. Past sexual partners from the last 60 days should also get tested and treated with antibiotics.
Sometimes, providers use expedited partner therapy to treat partners without a health visit. Three months after finishing antibiotic treatment, people should get retested for chlamydia to check for reinfection.
Getting treated once does not protect against getting infected again.
Getting Ready for Your Visit
Steps You Can Take Before the Appointment
Write down when your symptoms first appeared.
Note if anything helps or makes your symptoms worse.
List any medications or supplements you currently take.
- Prepare questions for the healthcare provider. Some examples are:
- Should tests be done for other sexually transmitted infections?
- Does a partner also need testing or treatment?
- Is it necessary to avoid sexual activity during treatment, and for how long?
- What steps help lower the risk of getting chlamydia again?
Bring this information and your questions to the visit. This preparation can help you get useful advice on prevention, such as using condoms to reduce risks, especially if you have new partners.
Questions You Might Get From the Healthcare Provider
Expect to answer questions like:
| Question Type | Possible Questions |
|---|---|
| Sexual History | Have you had new or multiple partners? |
| Condom/Prevention Use | Do you use condoms every time you have sex? |
| Symptoms | Are you having pain, discharge, or sores? |
| Risk Factors | Are you part of any higher-risk group, such as men who have sex with men (MSM)? |
The healthcare provider asks these questions to understand your risks. This helps them give you the best care and advice on prevention.
