Chlamydia Trachomatis/Urethritis (Antimicrobial)

Warning
  • 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 flowchart for Uncomplicated (asymptomatic) chlamydia for patients attending GP practices.

Patient information is available here: https://highlandsexualhealth.co.uk/stis/chlamidya.

Drug details

Chlamydia trachomatisuncomplicated (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

Last reviewed: 27/02/2023

Next review date: 27/02/2026

Author(s): Antimicrobial Management Team.

Approved By: TAM Subgroup of ADTC

Reviewer name(s): Alison Macdonald, Area Antimicrobial Pharmacist.

Document Id: AMT124