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Chlamydia Information for Health Professionals

Chlamydia facts


  • There is an epidemic of Chlamydia trachomatis in the Hunter New England region and throughout Australia.
  • Chlamydia infection can occur at any age but infection is most common in young adults under the age of 25 years. Up to 10% of young people have the infection.
  • It is a common infection in both males and females.
  • It is a major preventable cause of infertility and can cause ectopic pregnancy and chronic pelvic pain.
  • It can increase the risk of HIV transmission.
  • Most infections (in men and women) are asymptomatic (up to 90%).
  • Infection can persist for years if untreated.
  • It is highly infectious – at least 50% of partners of a confirmed case will be infected. Treating contacts is thus very important (see below).

Target groups for testing


The following people should be offered routine testing at least annually:

  • sexually active men and women under the age of 25
  • men who have sex with men
  • sex industry workers

Testing is also recommended for people who have:

  • a history of inconsistent condom use
  • recent partner change
  • unplanned pregnancy
  • symptoms suggestive of chlamydia
  • another STI
  • a sexual partner with chlamydia

Chlamydia symptoms


  • Most men and women (up to 90%) will have no symptoms.
  • In women, infection may result in pain on urination, lower abdominal pain, or intermenstrual or post coital bleeding.
  • In men, infection may result in urethral discharge, pain on urination or urethral irritation.

Test options


  • The chlamydia PCR test is highly sensitive (95%+) and specific (95%+).
  • For men: Initial stream urine taken at any time of the day (plus an anal swab if indicated)*
  • For women: Initial stream urine or a cervical swab (plus an anal swab if indicated).* Other options include a Thin Prep specimen, or a high vaginal swab. 

Treatment options for uncomplicated infection


  • Azithromycin 1000mg stat; or
  • Doxycycline 100mg b.d. for 7 days. (not for use in pregnancy or breast feeding)

In pregnancy:

  • Azithromycin 1000mg stat  (Category B1);   or
  • Amoxicillin 500mg tds for 10 days  (Category A);   or
  • EES 800mg bd for 10 days  (Category A)

Patient Follow-up


  • A repeat test should not be conducted less than 4 weeks after the initial positive test due to the likelihood of bacterial DNA still being present.
  • It is recommended that a pregnant woman testing positive be tested for cure at 4 weeks after treatment.
  • All others with a positive test should be retested at 3-6 months because of the high risk of reinfection.
  • The frequency of further testing should then be based on an assessment of continuing risk factors.

Contact Tracing


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