Chlamydial Genitourinary Infections Guidelines

Updated: Jul 14, 2017
  • Author: Shahab Qureshi, MD, FACP; Chief Editor: Michael Stuart Bronze, MD  more...
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Guidelines

WHO Guidelines on the Treatment of Chlamydia trachomatis Infection

Guidelines on treatment of Chlamydia trachomatis infection by the World Health Organization (WHO) are summarized below. [63]

Uncomplicated Genital Chlamydia

WHO recommendations for the treatment of uncomplicated genital chlamydia are as follows:

  • Azithromycin 1 g orally as a single dose or
  • Doxycycline 100 mg orally twice a day for 7 days or one of these alternatives: tetracycline 500 mg orally 4 times a day for 7 days, erythromycin 500 mg orally twice a day for 7 days, or ofloxacin 200-400 mg orally twice a day for 7 days

Anorectal Chlamydial Infection

In anorectal chlamydial infection, the WHO recommends doxycycline 100 mg orally twice a day for 7 days over azithromycin 1 g orally as a single dose.

Chlamydial Infection in Pregnant Women

WHO recommendations for the treatment of chlamydial infection in pregnancy are as follows:

  • Azithromycin recommended over erythromycin
  • Azithromycin recommended over amoxicillin
  • Amoxicillin recommended over erythromycin
  • Azithromycin 1 g orally as a single dose or
  • Amoxicillin 500 mg orally 3 times a day for 7 days or
  • Erythromycin 500 mg orally twice a day for 7 days

Lymphogranuloma Venereum

WHO recommendations for the treatment of lymphogranuloma venereum (LGV) are as follows:

  • In adults and adolescents with LGV, the guidelines suggest doxycycline 100 mg orally twice daily for 21 days over azithromycin 1 g orally weekly for 3 weeks.
  • Good practice dictates treatment of LGV, particularly for men who have sex with men and for people with HIV infection.
  • When doxycycline is contraindicated, azithromycin should be provided.
  • When neither treatment is available, erythromycin 500 mg orally 4 times a day for 21 days is an alternative.
  • Doxycycline should not be used in pregnant women.