Chlamydia

NICE CKS Chlamydia - uncomplicated genital. Last revised Feb 2025. BASHH Chlamydia 2015. Last updated Sep 2018. UK Health Security Agency Guidance NCSP: programme overview. Last updated Jun 2021.

Guidelines

According to the National Chlamydia Screening Programme (NCSP), the following should be offered a chlamydia test:
  • Partner with chlamydia or symptoms of chlamydia infection
  • All sexually active women <25 y/o (to be tested yearly and after having sex with a new partner)
  • All sexually active women <25 y/o access sexual health service / contraception service / termination of pregnancy service

Test of choice: NAAT.

Sample collection methods:
  • Male 1st line: first pass urine (alterantive: urethral swab)
  • Female 1st line: vulvovaginal swab (alternative: endocervical swab or first pass urine)

Refer ALL patients to GUM (genito-urinary medicine) clinic / local specialist for management.
 

Abstain from all sexual activity until 7 days after they and their partner(s) have completed treatment

1st line: oral doxycycline100mg BD for 7 days

2nd line: oral azithromycin 1g OD for 1 day followed by 500mg OD for 2 days

3rd line: oral erythromycin
 

  • Discuss with GUM and specialist
  • Options include: azithromycin, erythromycin, amoxicillin
  • Test of cure is routinely needed in pregnant patients
 
 

Doxycycline is contraindicated in pregnancy and breastfeeding.

 

  • If symptomatic men → notify all partners within the past 4 weeks (1 month) (or most recent partner if more than 4 weeks ago)

  • If all other patients (i.e. asymptomatic men and women) → notify all partners within the past 6 months

Test of cure is NOT routinely recommended.

Exceptions:
  • Pregnant patients
  • Poor compliance
  • Persistent symptoms 

Test of cure should be performed at least 3 weeks after completion of treatment

Repeat testing indications:
  • Offer to all <25 y/o diagnosed with chlamydia, 3-6 months after completion of treatment
  • Consider if >25 y/o who are at high risk of re-infection
Author: Adams Lau
Reviewer:
Last edited: 04/05/25