Chlamydia Trachomatis/Urethritis (Antimicrobial)
TAM (Treatments and Medicines) NHS Highland
For complicated infection, including PID and epididymo-orchitis, recurrent or persistent symptoms: refer to sexual health.
- Testing is by NAAT/PCR of urine or swab (throat, vaginal, rectal) depending on sexual history and anatomy.
- Testing should always be carried out prior to treatment initiation.
- Full STI screening should be offered to also include gonorrhoea, HIV and syphilis.
- Partner(s) will require testing +/- treatment.
- Refer to Highland Sexual Health for partner notification.
Azithromycin is now second line due to rising resistance in Mycoplasma genitalium, a common co-infection with Chlamydia trachomatis.
- See: BASHH Chlamydia Guidelines (update September 2018).
For asymptomatic infection see: Uncomplicated (asymptomatic) chlamydia in primary care.
Patient information: https://highlandsexualhealth.co.uk/stis/chlamidya.
Drug details
Chlamydia trachomatis - uncomplicated (asymptomatic)
Doxycycline 100mg twice daily
7 days
Second line – see note above
OR Azithromycin 1g stat then 500mg once daily for 2 more doses
3 days (2g) in total
For rectal infections
Doxycycline 100mg twice daily
7 days
In pregnancy
Azithromycin 1g stat then 500mg once daily for 2 more doses
for 3 days (2g) in total
As per BNF use only if potential benefit outweighs risk.
OR Erythromycin 500mg 4 times daily
7 days
As per BNF use only if potential benefit outweighs risk.
OR Erythromycin 500mg twice daily
14 days
OR Amoxicillin 500mg 3 times daily
7 days