Chlamydial infection
Infection caused by Chlamydia trachomatis. Often asymptomatic. Untreated, it leads to pelvic inflammatory disease and infertility.
ICD-10 A563 drugs
Also known as: Chlamydia, Urogenital chlamydia
Drugs used for this condition
- ADoxycyclineFirst line · TetracyclinesFirst-line for uncomplicated chlamydial infection alongside azithromycin. Doxycycline 100 mg twice daily for 7 days. Recent meta-analyses suggest a slight advantage over single-dose azithromycin in eradication rates. In men with chlamydial proctitis, doxycycline is preferred.
- AErythromycinSecond line · Macrolide antibioticTreats urogenital chlamydia in pregnancy as an azithromycin alternative. AEMPS considers erythromycin ethylsuccinate safe in gestation.
- BAzithromycinSecond line · MacrolidesPer the current CDC STI Treatment Guidelines 2021, first-line for uncomplicated chlamydial infection is doxycycline 100 mg twice daily for 7 days (better eradication, especially in rectal chlamydia and LGV). Azithromycin 1 g single oral dose is an alternative when doxycycline cannot be used (pregnancy, intolerance). Eradication with the single dose exceeds 90 % but is lower than with doxycycline. The European IUSTI 2015 guideline likewise prefers doxycycline and keeps azithromycin as an alternative.
How to read tiers A–F
Evidence tiers belong to the drug-indication pair, not to the drug as a whole: the same substance can be A for one condition and F for another.
- AStrong evidence – first or second line in international guidelines
- BRecommended in selected cases
- CStudy data contradict each other
- DBenefit not proven, no documented harm
- FDocumented harm, or risk without benefit