Chlamydia Treatment

Azithromycin used to be one of the recommended treatments for chlamydia but this has now changed. In September 2018 the British Association for Sexual Health and HIV released guidelines explaining that Azithromycin is no longer recommended for treating chlamydia because of increasing bacterial resistance to it. Now the only recommended first-line treatment for chlamydia is doxycycline.

Chlamydia is a common sexually transmitted infection. You can get it by having unprotected sex (vaginal, anal or oral); or from skin to skin contact of your genitals with another person's; from sharing unwashed sex toys or using them without a condom.

It is caused by a bacteria called Chlamydia trachomatis that lives in semen and vaginal fluids.

Chlamydia normally infects the genitals, but it can also infect the rectum, eyes or throat.

When the rectum is infected, the cause may be a variant of Chlamydia known as Lymphogranuloma venereum or LGV.

This can present with symptoms such as a single painless lesion or ulcer or multiple lesions that appear to look like herpes. Pain or burning on passing urine is also common when it is first contracted.

In the first month after getting the infection people may feel generally unwell, with fever, muscle aches, headache, tiredness, loss of appetite, nausea and vomiting, and may also note enlarged and painful lymph nodes near their genitalia.

Late symptoms which may show many years after the infection is initially caught may include; mucus or bloody rectal discharge, anal itching, rectal pain and feelings of incomplete evacuation of your bowels as well as the passage of thin stools with constipation.

LGV will not be adequately treated with just one week of Doxycycline and requires 3 weeks of treatment instead.

Risk if untreated – if left untreated, chlamydia can cause very serious health problems. In women this includes pelvic inflammatory disease, which can cause infertility (not being able to have children) and increased risk of miscarriage.

In men, chlamydia can result in infertility (not being able to have children), swollen testicles (orchitis), and reactive arthritis (inflammation of the joints).

Simple antibiotic treatment – you can treat chlamydia very easily with a single course of antibiotics. These antibiotics limit the infection and stop it reproducing, so that your body’s immune system can fight off the infection.

95% of people who take their antibiotics according to the instructions on the prescription find that this successfully gets rid of the chlamydia infection.

Treatment can be different for certain people – your doctor might suggest a different type of antibiotic if you are pregnant, breastfeeding or if you seem to have had chlamydia for a long time. You must complete the course of antibiotics, even if your symptoms seem to have cleared up and avoid all sexual contact including with a condom during the time of treatment. Sexual contact both with or without a condom can be resumed after the course has been completed.

Telephone consultation – if you would like personalised advice or have any questions about chlamydia, you can book a telephone consultation with one of our doctors.

Side effects – occasionally you might get a rash as a side effect from Doxycycline if you are exposed to too much sunlight and therefore should protect yourself from the sun during the treatment. It can also cause nausea and vomiting but the risk of this can be reduced by taking the medication with food or fluids and sitting up for at least 30 minutes afterwards.

For a full list of side effects always read the manufacturer's leaflet before starting doxycycline.

Alternative treatments – your doctor might suggest a different type of antibiotic if you are pregnant, breastfeeding or if you seem to have had chlamydia for a long time. Ofloxacin and Erythromycin are other common antibiotics.

Contacting partners – if a test shows that you’ve got chlamydia, you should contact recent sexual partners (anyone from the last six months) and let them know. The NHS has specialist sexual health advisors who can help you do this, or who can offer to do it for you if you’d prefer not to have the conversation yourself.

Yes, you can still pass on chlamydia even if you are being treated – this is because the treatment hasn’t killed off enough of the bacteria to make you non-contagious.

Having sex – we don’t recommend that you have sex, even with a condom, until you finish your treatment. If your partner also has chlamydia, you shouldn’t have sex until you have both finished the treatment. Otherwise, you risk catching/passing on the infection again.

All sexual contact including with a condom should be avoided during treatment.

You should take the tablets exactly as they have been prescribed – if you are on a seven-day course, try to take them at around the same time every day. If you think you are likely to forget to take tablets twice a day for a week, you could ask for a one-day course of treatment.

Avoid sex – to look after yourself, you should not have sex, even with a condom, until you have finished the chlamydia treatment. This increases the chance of you passing it on or catching it again. Try to eat normally and drink lots of fluids to help your body fight off the infection.

Alcohol – do not drink alcohol during your treatment as this reduces the effectiveness of the treatment.

Improving any symptoms – most people don’t notice any symptoms when they get chlamydia. You might have noticed some pain (especially when urinating) or abnormal bleeding (if you are a woman), however. You can take over-the-counter painkillers such as paracetamol or Ibuprofen if the pain bothers you. Make sure you read and follow the instructions of these over-the-counter painkillers.

Under 25 years old – if you need chlamydia treatment and are under the age of 25 you should repeat a test 3 months after your treatment.

When to get more help – if you take the full course of antibiotics, the chlamydia infection should clear up after a week. Go to a sexual health clinic or seek advice from a nurse or doctor if any of these things happen:

• You have sex, even with a condom, during your chlamydia treatment
• You miss a tablet or are sick or have diarrhoea after a tablet
• You were pregnant when you started treatment
• The symptoms of chlamydia didn’t stop a week after your treatment
• You have a fever or severe tummy pain
• You are a man and have discharge from your back passage