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Chlamydia testing and management: a framework for north derbyshire

PRIORITIES AND CLINICAL EFFECTIVENESS FORUM
CHLAMYDIA TESTING & MANAGEMENT
o This is a guideline produced jointly by GUM and contraception &
sexual health
o Its aim is to ensure consistent management of chlamydia
throughout North Derbyshire
o The guidance is to complement not replace existing GUM services
o The patient leaflet should be given out at the time of screening
PACEF North Derbyshire Guideline – Chlamydia testing & management
Chlamydia testing and management: a
framework for North Derbyshire
Who to test for chlamydia infection
When else to test
Women Men
Mothers of babies with chlamydial conjunctivitis More than 2 partners in last 6 months / change partner / screening <25yo / on request
Which sample?
1. An endocervical swab if having a VE or First void urine-15ml more than 2 hours after 3. *First-void urine (* only if test used is
women, urine testing has poor sensitivity (~62%) therefore a swab would be better.) Starting treatment
Initiate treatment without waiting for results in those in whom you suspect infection (symptomatic).
Ensure that treatment is offered to sexual partners.
Advise no sex including oral until treatment completed for all sexual partners.
Advise triple swabs in women to screen for other infections if these have not been performed. Referral to
GUM for men.
Which antibiotic? Treatment is free in GUM but not in primary care.
Uncomplicated

Risk of pregnancy
Suspected PID
Epidymitis/orchitis
infection
Azithromycin 1g stat
Erythromycin 500mg bd Ofloxacin 400mg bd 14 for 14 days or 500mg
Doxycycline100mg bd + Ofloxacin 200mg bd for *This regime has a lower cure rate than the others. Use only if unable to tolerate erythromycin.
Partner notification (support from trained health advisers is strongly recommended)
Symptomatic patients Asymptomatic
All partners from 4 weeks prior to the development
of symptoms
Follow up- depends on the treatment given
After azithromycin, doxycycline nil needed
After erythromycin, amoxycillin re-test at least 3 weeks after treatment completed. Please give leaflets about chlamydia – these are available via the PCT websites. Do you need further advice /support? The dept of GUM are pleased to help you. Please contact by e-mail: or r tel: GUM 01246 512121 Community health advisers are contactable at Saltergate HC, 01246 514600. PACEF North Derbyshire Guideline – Chlamydia testing & management Chlamydia

What is chlamydia?

Chlamydia is a germ infecting the genitals. It can also sometimes infect the eyes or the throat. It is one of the most common sexually shared infections.
In men it causes inflammation in the urethra (pipe in the penis). In women it usually infects the cervix
(neck of the womb) and / or the urethra (passage from the bladder).
How is chlamydia caught?
Chlamydia is passed through sexual intercourse with an infected person. The germs may go unnoticed for
some time (weeks, months or even years).
You cannot catch chlamydia from swimming, or sharing a bath or a towel with someone who is infected.
Nor can it be caught from toilet seats, cups or plates or a friendly kiss or hug.
What are the symptoms?

Men and women
Infection may go unnoticed. About half of those with chlamydia do not realise that they are carrying the
germ.
Men
Pain or stinging when passing urine
Clear or white discharge from the tip of the penis
Women
Increased vaginal discharge
Pain or stinging on passing urine
Bleeding between periods or after sex
Pelvic pain or pain during sex
Tests for chlamydia

Men- a urine sample taken at least2 hours after you last passed urine
Women- a swab from the cervix or a urine sample. Or a swab from the vagina taken yourself.
You may have had tests because you believe yourself to be at risk of infection
It is also usual for a doctor or nurse to take swabs for chlamydia if you have unexplained pelvic pain,
vaginal discharge or irregular bleeding.
Chlamydia tests are also routinely performed before a coil is fitted or before a termination of pregnancy.
PACEF North Derbyshire Guideline – Chlamydia testing & management
How Will I get my results?
Please make sure you know how you are going to get the results of your chlamydia test.
Please ensure we have your mobile phone number or other contact number so that we can contact you if
necessary.
Treatment for chlamydia

Chlamydia can be treated with antibiotics. Please complete the course given to you.
It is important that your partner is offered treatment.
You should avoid having sex (vaginal or oral) until your treatment has finished and until your partner or
partners have been treated.
Unfortunately having chlamydia once will not protect you from getting it again.
What if I don’t get treated?
If left untreated chlamydia can lead to complications.
Men
-chlamydia infection can spread to the testicles and the tubes lying behind the testicle (the epidymis). This is usually quite painful. – chlamydia can lead to pelvic infection with symptoms of pain, fever and discomfort during sex. Untreated it can lead to infertility.
What shall I tell my partner?
It may be difficult to discuss possible sexually shared infection with your Partner. Remember that sexually shared infections are common. If one of you has an infection it is likely that the other also has an infection, especially if you are not using condoms to protect against sexually shared infections. Please ask if you would like advice about how to talk about this with your partner. Remember, until your partner is treated you are at risk of getting further infection. PACEF North Derbyshire Guideline – Chlamydia testing & management

Source: http://www.derbyshire.nhs.uk/clinical/Chlamydia%20Guideline06(5).pdf

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