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Chlamydia facts
- There is an epidemic of Chlamydia trachomatis in the Hunter New England region and throughout Australia.
- Chlamydia infection can occur at any age but infection is most common in young adults under the age of 25 years. Up to 10% of young people have the infection.
- It is a common infection in both males and females.
- It is a major preventable cause of infertility and can cause ectopic pregnancy and chronic pelvic pain.
- It can increase the risk of HIV transmission.
- Most infections (in men and women) are asymptomatic (up to 90%).
- Infection can persist for years if untreated.
- It is highly infectious – at least 50% of partners of a confirmed case will be infected. Treating contacts is thus very important (see below).
Target groups for testing
The following people should be offered routine testing at least annually:
- sexually active men and women under the age of 25
- men who have sex with men
- sex industry workers
Testing is also recommended for people who have:
- a history of inconsistent condom use
- recent partner change
- unplanned pregnancy
- symptoms suggestive of chlamydia
- another STI
- a sexual partner with chlamydia
Chlamydia symptoms
- Most men and women (up to 90%) will have no symptoms.
- In women, infection may result in pain on urination, lower abdominal pain, or intermenstrual or post coital bleeding.
- In men, infection may result in urethral discharge, pain on urination or urethral irritation.
Test options
- The chlamydia PCR test is highly sensitive (95%+) and specific (95%+).
- For men: Initial stream urine taken at any time of the day (plus an anal swab if indicated)*
- For women: Initial stream urine or a cervical swab (plus an anal swab if indicated).* Other options include a Thin Prep specimen, or a high vaginal swab.
Treatment options for uncomplicated infection
- Azithromycin 1000mg stat; or
- Doxycycline 100mg b.d. for 7 days. (not for use in pregnancy or breast feeding)
In pregnancy:
- Azithromycin 1000mg stat (Category B1); or
- Amoxicillin 500mg tds for 10 days (Category A); or
- EES 800mg bd for 10 days (Category A)
Patient Follow-up
- A repeat test should not be conducted less than 4 weeks after the initial positive test due to the likelihood of bacterial DNA still being present.
- It is recommended that a pregnant woman testing positive be tested for cure at 4 weeks after treatment.
- All others with a positive test should be retested at 3-6 months because of the high risk of reinfection.
- The frequency of further testing should then be based on an assessment of continuing risk factors.
Contact Tracing
- All sexual contacts for the past 6 months should be offered empirical treatment for chlamydia and tested for chlamydia and other STIs. A contact letter is available for use during this process. To download a contact tracing letter, see the Resources and Links page.
- Further information for clinicians is available in the Australasian Contact Tracing Manual
- Contact tracing information for patients is available elsewhere on this site. Patients can be directed to this resource by giving them the following web address: www.chlamydiahelp.net
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