Chlamydia Treatment: Guidelines & Meds (Adults, Pregnancy, Children)

Chlamydia treatment is done with prescription antibiotics, typically with medications like azithromycin or doxycycline. These medicines should be taken exactly as directed by a healthcare professional to make sure the infection is fully cleared.

During treatment, it is also important to avoid vaginal, anal, or oral sex. Sexual partners should be treated at the same time to help prevent reinfection or spreading the bacteria to others.

Chlamydia is a sexually transmitted infection caused by the bacterium Chlamydia trachomatis. It can affect both men and women and may cause symptoms such as unusual genital discharge or burning during urination, although many people have no symptoms at all.

Medications for chlamydia

Treatment for chlamydia involves specific antibiotics that must be prescribed by a healthcare professional.

First-line medications

The primary recommended treatment options are typically prescribed by a gynecologist or urologist. 

Doxycycline is considered the first-line antibiotic for chlamydia treatment, according to the Centers for Disease Control and Prevention (CDC). It is prescribed as:

• Doxycycline 100 mg twice a day for 7 days

It must be taken at this exact dose and duration, even if symptoms improve quickly. If symptoms persist after finishing treatment, it is important to return to the doctor for further evaluation.

Alternative medications

Other effective antibiotic options may be used when first-line treatments are not suitable, such as:

• Azithromycin 1 g taken as a single dose

• Levofloxacin 500 mg once a day for 7 days

These alternatives are typically used when doxycycline cannot be taken, such as in cases of intolerance, contraindications, or other clinical considerations (including pregnancy, difficulty completing a 7-day regimen, significant gastrointestinal side effects, or known allergy to tetracyclines).

Treatment during pregnancy

During pregnancy, antibiotics should be prescribed by an obstetrician. Treatment may include a single dose of azithromycin or amoxicillin taken three times a day for 7 days.

Treatment in babies and children

In babies, treatment should be prescribed by a neonatologist or pediatrician. They may recommend erythromycin, with the exact dose adjusted according to the baby’s weight.

For children who weigh more than 45 kg and are under 8 years old, the pediatrician may prescribe antibiotics appropriate for this age group. In children older than 8 years, the pediatrician may prescribe azithromycin or doxycycline.

Signs of improvement or worsening

People with symptoms of Chlamydia trachomatis infection often start to feel better after two or three days of treatment. However, those without symptoms may not notice any visible change, even though the infection is still being treated effectively.

To confirm clearance in these cases, a microbiological culture of the genital area may be recommended to check for the presence or absence of the bacteria, according to the Centers for Disease Control and Prevention (CDC).

If symptoms worsen or complications begin to appear, such as pelvic pain or infertility, this may suggest that treatment was not completed correctly or that the infection has progressed.

Possible complications

When chlamydia is not treated properly or if it left untreated, complications may include:

• Infertility

• Pelvic inflammatory disease in women

• Inflammation of the testicles (epididymitis)

• Inflammation of the urethra

• Pelvic adhesions

• Salpingitis (chronic inflammation of the fallopian tubes)

• Chronic pelvic pain

• Ectopic pregnancy

• Fallopian tube obstruction

Men may also develop Reiter’s syndrome, which includes inflammation of the urethra, severe conjunctivitis called trachoma, arthritis, and localized lesions on the genitals.