Reproductive and sexual health providers could reference evidence-based national guidelines for chlamydia screening and care, including guidelines from the U.S. Preventive Services Task Force (USPSTF), the Centers for Disease Control and Prevention (CDC), and the American Academy of Family Physicians (AAFP).
• American Academy of Family Physicians: The AAFP’s research revealed that infections caused by both Chlamydia trachomatis and Neisseria gonorrhoeae are increasing in the United States.1
Screening is key to preventing complications because most infections are asymptomatic. AAFP recommends that all sexually active people with a cervix who are younger than age 25 years, as well as older people with risk factors, be screened each year for both sexually transmitted infections (STIs). Specimen types for testing include vaginal, endocervical, rectal, pharyngeal, and urethral swabs and first-stream urine samples.
• Centers for Disease Control and Prevention: The CDC recommends annual screening of all sexually active women, ages 24 years and younger, as well as screening of older women at greater risk of infection.2
C. trachomatis urogenital infection in women can be diagnosed by vaginal or cervical swabs or first-void urine sample. Recommended treatment for chlamydial infection among adolescents and adults is 100 mg of doxycycline, two times per day, for seven days. Alternatives are azithromycin at 1 g orally in a single dose or levofloxacin, 500 mg orally once daily for seven days.
Patients treated for chlamydia should be told to abstain from sexual intercourse for seven days after single-dose therapy or until completing a seven-day regimen and resolution of symptoms.
• U.S. Preventive Services Task Force: The USPSTF recommends screening for chlamydia in all sexually active women, ages 24 years or younger, and in older women at greater risk for infection.
The organization’s recommendations point to the importance of screening for chlamydia infection because it is usually asymptomatic in women and could lead to pelvic inflammatory disease and complications that include ectopic pregnancy, infertility, and chronic pelvic pain. Also, newborns of people with untreated infection may develop neonatal chlamydial pneumonia or chlamydial ophthalmia.3
Screening tests include the nucleic acid amplification test for C. trachomatis and N. gonorrhoeae infections.
REFERENCES
- Yonke N, Aragón M, Phillips JK. Chlamydial and gonococcal infections: Screening, diagnosis, and treatment. Am Fam Physician 2022;105:388-396.
- Centers for Disease Control and Prevention. Chlamydial infections. Page last reviewed July 22, 2021. https://www.cdc.gov/std/treatm...
- U.S. Preventive Services Task Force. Chlamydia and gonorrhea: Screening. Sept. 14, 2021. https://www.uspreventiveservic...
Reproductive and sexual health providers could reference evidence-based national guidelines for chlamydia screening and care, including guidelines from the U.S. Preventive Services Task Force, the Centers for Disease Control and Prevention, and the American Academy of Family Physicians.
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