Treatment of chlamydia in pregnancy

Chlamydia infection should be managed at a specialist genitourinary medicine (GUM) clinic. The GUM clinic will be able to screen for further sexually transmitted diseases and undertake contact tracing.

Chlamydia treatment if pregnant/breastfeeding in adult:

• azithromycin 1g stat for one day; then 500mg once daily for two days (total course 3 days)

Key points:

• opportunistically screen all sexually active patients aged 15 to 24 years for chlamydia annually and on change of sexual partner
• if positive, treat index case, refer to GUM and initiate partner notification, testing and treatment
• advise patient with chlamydia to abstain from sexual intercourse for 7 days after treatment with azithromycin (14 days after azithromycin started and until symptoms resolved if urethritis)
• if chlamydia, test for reinfection at 3 to 6 months following treatment if under 25 years; or consider if over 25 years and high risk of re-infection
• as lower cure rate in pregnancy, test for cure at least 3 weeks after end of treatment.
• consider referring all patients with symptomatic urethritis to GUM as testing should include Mycoplasma genitalium and Gonorrhoea.

Reference:

• Public Health England (June 2021). Managing common infections: guidance for primary care