As bacterial infection, chlamydia is treated with different types of antibiotic medicine. Some of them might be administered as one-off dose, while others might be used over the course of several days or even weeks. As of now, the most commonly prescribed chlamydia treatments (sometimes referred to as first-line treatments) are a potent one-off antibiotic Azithromycin and Doxycycline which is taken twice daily over the course of one week.
Doxycycline is usually the preferred option if the infection is present within the rectum, while Azithromycin is used in all the other cases. However, in some cases neither of the two will be suitable for the patient. When that occurs, second-line treatments will be considered.
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Why is it important to treat chlamydia?
When left untreated, chlamydia can cause significant complications and severe health conditions, including sterility in both sexes. Women are also at risk of pelvic inflammatory disease, while men might develop epididymitis, the inflammation of the testicles. In addition to this, those who do not seek out treatment will continue passing the infection to their sexual partners.
It is also important to note that the body’s natural defences cannot fight off the infection on their own, so treatment is necessary in order to give the immune system a chance of clearing chlamydia out of the body.
What antibiotics are prescribed for chlamydia treatment?
According to NICE guidelines, Azithromycin and Doxycycline should be used as first-line treatments for uncomplicated genital chlamydia infections, with Doxycycline being prescribed in those cases where rectal infection is also present and Azithromycin in other cases.
What are second-line chlamydia treatments?
If the first-line treatments are not suitable for any given patient due to their medical profile, second-line treatments will be considered by the doctor. This hierarchical structure based on the preference for certain medicines (if their use is not contraindicated) led to the emergence of terms such as first-line, second-line, third line treatments, and so on.
Most commonly, second-line treatments are prescribed if neither Azithromycin nor Doxycycline are suitable for the patient. This can occur if, for example, there is a pre-existing medical condition that might make the use of these medicines dangerous, or if the patient is intolerant to some of the constituent compounds of the medicines.
In the case first-line treatments are contraindicated, NICE guidelines recommend the following:
- Erythromycin course with 500mg dose (twice daily) for ten days to two weeks
- Ofloxacin 200mg twice daily over the course of one week
How is chlamydia treated during pregnancy?
Pregnant women are a very specific case when it comes to chlamydia treatment. This is so because not only there is a risk of passing on the infection to the baby, but also because neither Doxycycline nor Ofloxacin are suitable for use during pregnancy. In this scenario, doctor may recommend:
- One-off dose of Azithromycin (1g)
- Seven day course of Erythromycin (500mg, taken four times per day)
- 14-day course of Erythromycin (500mg, twice daily)
- A week course of Amoxicillin (500mg, three times per day)
Of course, these are just the most general guidelines – every patient comes with a specific medical history and specific issues which might have significant impact on how the treatment is conducted.
Should I start chlamydia treatment before getting STI test results?
There are certain situations when a doctor may advise you to begin chlamydia treatment even before obtaining your STI test results or even taking a test at the first place. This might happen if the doctor is able to diagnose your condition via strongly indicative symptoms, or if you partner got confirmation regarding the presence of the infection. The exception to this are those cases where there is suspicion that the transmission of chlamydia might have taken place, but there are no noticeable symptoms. In this scenario, the doctor will advise you to wait for the results of the test prior to starting the treatment.
However, even in these cases, the patients should still get tested in order to confirm their diagnosis.
Where can I get chlamydia treatment?
The most reliable place where you can get tested and treated for chlamydia (and other STIs too) is a genitourinary medicine (GUM) clinic. There you will get access to specialist services, including professional medical advice, laboratory testing and examination, assistance in notifying partners and so on. After the testing has been done, those who tested positive will be invited to return to the clinic where they will get a prescription for proper treatment and an opportunity to discuss their condition with sexual health expert.
If you suspect you might have chlamydia or any other STI, you general practitioner will surely advise you to visit a GUM clinic. However, if the patient is unable or unwilling to do so, then your doctor might offer you testing and treatment in the general purpose health institution.
However, if you would like to avoid talking to healthcare professionals face-to-face altogether, your best option would be an online pharmacy. There you will be able to order a self-testing kit and, in majority of cases, get an opportunity for remote online consultations with a doctor. If you test positive on your at-home STI testing kit, you can use the opportunity to consult with a doctor online and get the proper medicine delivered straight to your doorstep.
How antibiotics used in the treatment of chlamydia work
Once bacteria causing chlamydia has found a way within a person’s body, it will inhabit the mucous membranes and begin to multiply. What we commonly call infection spread is actually the result of this process of multiplication when new bacteria is formed and it starts to colonise other bodily parts and not just those that were originally infected.
However, in order to grow and replicate, bacteria need to synthesize a specific protein, an enzyme that serves as a kind of catalyst in the process of multiplication. Most of the antibiotics used for the treatment of chlamydia work by inhibiting the activity of that enzyme, effectively halting the spread of infection and rendering the bacteria unable to replicate. Once this is accomplished, the infection can be easily cleared by the body’s immune system.