Chlamydia Treatment & Management

  • Author: Mounir Bashour, MD, CM, FRCS(C), PhD, FACS; Chief Editor: Hampton Roy Sr, MD   more...
 
Updated: Feb 17, 2010
 

Medical Care

  • Simultaneous treatment of all sexual partners is important to prevent reinfection. It also is prudent to examine all sexual partners for other venereal diseases, such as gonorrhea, syphilis, and HIV. It may also be wise to treat all members of the household with antibiotics.[5]
  • Treatment consists of systemic antibiotics; topical antibiotics are relatively ineffective in the treatment of this eye disease.
    • Recommended treatment, which is given for 3-6 weeks, includes oral tetracycline (500 mg qid), oral doxycycline (100 mg bid), or oral erythromycin stearate (500 mg qid).
    • Azithromycin can be given as a single dose of 1 g, which can be increased to 2 g if Neisseria gonorrhoeae is suspected.
    • Tetracyclines are avoided in children younger than 7 years and in women who are pregnant or breastfeeding.
  • Also see the clinical guideline summary, Conjunctivitis, from the American Academy of Ophthalmology,[6] and one from the US Preventive Services Task Force,Behavioral counseling to prevent sexually transmitted infections: U.S. Preventive Services Task Force recommendation statement.[7]
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Consultations

Infectious disease specialist or sexually transmitted disease clinic as necessary

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Activity

No sexual activity until the course of treatment is complete.

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Contributor Information and Disclosures
Author

Mounir Bashour, MD, CM, FRCS(C), PhD, FACS  Assistant Professor of Ophthalmology, McGill University; Clinical Assistant Professor of Ophthalmology, Sherbrooke University; Medical Director, Cornea Laser and Lasik MD

Mounir Bashour, MD, CM, FRCS(C), PhD, FACS is a member of the following medical societies: American Academy of Ophthalmology, American Association for Pediatric Ophthalmology and Strabismus, American College of International Physicians, American College of Surgeons, American Medical Association, American Society of Cataract and Refractive Surgery, American Society of Mechanical Engineers, American Society of Ophthalmic Plastic and Reconstructive Surgery, Biomedical Engineering Society, Canadian Medical Association, Canadian Ophthalmological Society, Contact Lens Association of Ophthalmologists, International College of Surgeons US Section, Ontario Medical Association, Quebec Medical Association, and Royal College of Physicians and Surgeons of Canada

Disclosure: Nothing to disclose.

Specialty Editor Board

Fernando H Murillo-Lopez, MD  Senior Surgeon, Unidad Privada de Oftalmologia CEMES

Fernando H Murillo-Lopez, MD is a member of the following medical societies: American Academy of Ophthalmology

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD  Senior Pharmacy Editor, eMedicine

Disclosure: eMedicine Salary Employment

Christopher J Rapuano, MD  Professor, Department of Ophthalmology, Jefferson Medical College of Thomas Jefferson University; Co-Chairman of the Cornea Service, Co-Chairman of Refractive Surgery Department, Wills Eye Institute

Christopher J Rapuano, MD is a member of the following medical societies: American Academy of Ophthalmology, American Society of Cataract and Refractive Surgery, Contact Lens Association of Ophthalmologists, Cornea Society, Eye Bank Association of America, International Society of Refractive Surgery, and Pan-American Association of Ophthalmology

Disclosure: Allergan Honoraria Speaking and teaching; Allergan Consulting fee Consulting; Alcon Honoraria Speaking and teaching; Inspire Honoraria Speaking and teaching; RPS Ownership interest Other; Vistakon Honoraria Speaking and teaching; EyeGate Pharma Consulting; Inspire Consulting fee Consulting; Bausch & Lomb Honoraria Speaking and teaching

Lance L Brown, OD, MD  Ophthalmologist, Affiliated With Freeman Hospital and St John's Hospital, Regional Eye Center, Joplin, Missouri

Disclosure: Nothing to disclose.

Chief Editor

Hampton Roy Sr, MD  Associate Clinical Professor, Department of Ophthalmology, University of Arkansas for Medical Sciences

Hampton Roy Sr, MD is a member of the following medical societies: American Academy of Ophthalmology, American College of Surgeons, and Pan-American Association of Ophthalmology

Disclosure: Nothing to disclose.

References

  1. Rackstraw S, Viswalingam ND, Goh BT. Can chlamydial conjunctivitis result from direct ejaculation into the eye?. Int J STD AIDS. Sep 2006;17(9):639-41. [Medline].

  2. Coppens I, Abu el-Asrar AM, Maudgal PC, Missotten L. Incidence and clinical presentation of chlamydial keratoconjunctivitis: a preliminary study. Int Ophthalmol. 1988;12(4):201-5. [Medline].

  3. Salopek-Rabatic J. Chlamydial conjunctivitis in contact lens wearers: successful treatment with single dose azithromycin. CLAO J. Oct 2001;27(4):209-11. [Medline].

  4. Bersudsky V, Rehany U, Tendler Y, Leffler E, Selah S, Rumelt S. Diagnosis of chlamydial infection by direct enzyme-linked immunoassay and polymerase chain reaction in patients with acute follicular conjunctivitis. Graefes Arch Clin Exp Ophthalmol. Aug 1999;237(8):617-20. [Medline].

  5. Blake IM, Burton MJ, Bailey RL, Solomon AW, West S, Muñoz B, et al. Estimating Household and Community Transmission of Ocular Chlamydia trachomatis. PLoS Negl Trop Dis. 2009;3(3):e401. [Medline].

  6. [Guideline] American Academy of Ophthalmology Cornea/External Disease Panel. Conjunctivitis. National Guideline Clearinghouse. 2008.

  7. [Guideline] U.S. Preventive Services Task Force. Behavioral counseling to prevent sexually transmitted infections: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med. Oct 7 2008;149(7):491-6, W95. [Medline].

  8. Carta F, Zanetti S, Pinna A, Sotgiu M, Fadda G. The treatment and follow up of adult chlamydial ophthalmia. Br J Ophthalmol. Mar 1994;78(3):206-8. [Medline].

  9. Elnifro EM, Storey CC, Morris DJ, Tullo AB. Polymerase chain reaction for detection of Chlamydia trachomatis in conjunctival swabs. Br J Ophthalmol. Jun 1997;81(6):497-500. [Medline].

  10. Haller-Schober EM, El-Shabrawi Y. Chlamydial conjunctivitis (in adults), uveitis, and reactive arthritis, including SARA. Sexually acquired reactive arthritis. Best Pract Res Clin Obstet Gynaecol. Dec 2002;16(6):815-28. [Medline].

  11. Kalayoglu MV. Ocular chlamydial infections: pathogenesis and emerging treatment strategies. Curr Drug Targets Infect Disord. Mar 2002;2(1):85-91. [Medline].

  12. Miller K, Schmidt G, Melese M. How reliable is the clinical exam in detecting ocular chlamydial infection?. Ophthalmic Epidemiol. Jul 2004;11(3):255-62. [Medline].

  13. Nakagawa H. Treatment of chlamydial conjunctivitis. Ophthalmologica. 1997;211 Suppl 1:25-8. [Medline].

  14. Numazaki K, Chiba S, Aoki K. Evaluation of serological tests for screening of chlamydial eye diseases. In Vivo. May-Jun 1999;13(3):235-7. [Medline].

  15. Stenberg K, Mardh PA. Genital infection with Chlamydia trachomatis in patients with chlamydial conjunctivitis: unexplained results. Sex Transm Dis. Jan-Mar 1991;18(1):1-4. [Medline].

  16. Taylor HR, Fitch CP, Murillo-Lopez F, Rapoza P. The diagnosis and treatment of chlamydial conjunctivitis. Int Ophthalmol. 1988;12(2):95-9. [Medline].

 
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