Chlamydia

Chlamydial infection, caused by the bacterial pathogen Chlamydia trachomatis, is the most commonly reported communicable disease in Australia, and those under age 30 are most at risk. Frequently asymptomatic, particularly in women, chlamydia is simple to test and treat.

Symptoms
- 85-90% of individuals with chlamydia have no symptoms.
- However, if present, symptoms may include dysuria, penile urethral and vaginal discharge, testicular and pelvic pain, intermenstrual and postcoital bleeding, pain during sex and anorectal symptoms.
- Chlamydia can also cause a wide range of complications, including cervicitis, Pelvic Inflammatory Disease (PID), infertility, pregnancy-related complications (e.g., ectopic pregnancy), epididymo-orchitis, reactive arthritis and conjunctivitis.
Treatment
- Recommended first-line treatment for uncomplicated genital or pharyngeal infection for chlamydia is doxycycline 100 mg taken orally twice daily for 7 days.
- An alternative is a single dose of 1 gram oral azithromycin.
- To improve antibiotic stewardship, immediate treatment is not recommended for all sexual contacts of chlamydia. Instead, offer testing of exposed anatomical sites and await results.
Test of Cure
- Testing for re-infection is recommended at 3 months. Consider testing for other STIs if not undertaken at first presentation.
How to Order Chlamydia Testing
Request Form Instructions:
- Complete the Clinical Labs general pathology request form, listing chlamydia and any other required STIs.
- If the recommended STIs for asymptomatic screening are required (gonorrhoea, chlamydia, syphilis, HIV, Hepatitis B and Hepatitis C), write “STI Screen” in the Clinical Notes.
Specimen Details:
- Urethral swabs, first-pass urine (FPU) and vaginal/endocervical swabs. Note: Vaginal/endocervical swabs are more sensitive than FPU samples in female patients.
- Additionally, an anorectal swab for patients with anorectal symptoms and all Men Who Have Sex with Men (MSM), along with a pharyngeal swab for MSM.
- Serology for HIV, syphilis, Hepatitis B and Hepatitis C if these tests are also required.
Test Cost:
- Bulk-billed, subject to Medicare eligibility criteria.
Additional Resources: