1. Antibiotic: Complete the antibiotic prescribed, as soon as possible

2. Partner notification: Your current partner and any from the last six months should also have treatment for chlamydia.

3. Avoid sex for 7 days: You and your partner need to avoid sex for seven days from the first day of the antibiotic treatment.

4. Attend a GUM clinic for the screening of STIs: We advise that you also visit a GUM clinic to be screened for other sexually transmitted diseases.

5. Repeat the test 3-12 months later: Repeat the test to check for re-infection between 3-12 months, or sooner if there is a change of partner.

It is recommended that you visit a GUM /sexual health clinic for screening of other sexually transmitted infections including gonorrhoea, hepatitis B, HIV, and syphilis. This should be done at least 1 week after completing treatment. Your current partner should be treated as well regardless of any test result. ^3,5

It is important that previous partners (from the last 6 months are notified), you may choose to do this, or it can be done anonymously through a GUM clinic. ⁶ This to help reduce the spread of chlamydia. 

It is advised that sexual intercourse with or without condoms (including oral sex) is avoided for 7 days after the treatment is started, as this is how long it takes for the infection to clear. By following this, you reduce your chances of the treatment not working or becoming re-infected.

If you have a coil (IUD or IUS) then uncomplicated genital Chlamydia infection does not require removal of it.³

If you are under 25, then you are at a higher risk of catching Chlamydia again. You should have a retest done at 3 months. 

Young people are at a greater risk of acquiring chlamydia, however, it can occur at any age. Ideally, young sexually active people should be screened for chlamydia every year. In 2014 there were 206,774 new diagnoses of chlamydia infection, and 70% of those were under 25.² 

It is caused by the chlamydia bacteria spreading from one person to another through unprotected vaginal, anal or oral sex.

It can also spread through contact with infected vaginal fluids or semen. It cannot be passed through kissing or hugging.

It can also pass from a pregnant woman to her baby.

You may need to seek further advice from a GP or GUM clinic if any of the following apply:

• You had sex before you and your partner finish treatment
• You forgot to take your medication or didn't take it properly
• If your symptoms don't go away
• You were treated for chlamydia whilst pregnant

The antibiotic azithromycin is usually prescribed as first choice and it is taken as a single dose. Before you start the treatment read the manufacturers leaflet contained with the medication, which contains more information and the potential side effects.

The tablets should be taken together and can be taken either before or after food with 1⁄2 a glass of water.

Azithromycin is not thought to affect the ability to drive or operate machinery.

Do not take indigestion remedies during the two hours before or during the two hours after you take a dose of azithromycin, as it can affect the absorption of the antibiotic.

Never give your medication to other people even if their condition appears to be the same as yours.

Side-effects are usually mild and the most common are diarrhoea, feeling sick and a headache.

Serious side effects of Azithromycin are uncommon, but if you will need to contact a doctor straight away if you notice any of the following:

• diarrhoea that lasts a long time or has blood in it, with stomach pain or fever. This may be caused by serious bowel inflammation but only rarely happens after taking antibiotics.
• jaundice: Yellowing of the skin or whites of the eyes caused by liver problems
• severe abdominal pain in the neck or back caused by inflammation of the pancreas
• not passing enough urine or blood in the urine
• skin rash caused by sensitivity to sunlight
• unusual bruising or bleeding
• an irregular heartbeat.

The antibiotic Doxycycline 100mg to be taken twice a day for 7 days. Before you start the treatment read the manufacturers leaflet contained with the medication, which contains more information and the potential side effects.

How to take Doxycycline

Take doxycycline with plenty of water whilst standing or sitting up to stop the capsules from causing any irritation to your throat. Do not lie down for at least thirty minutes after taking Doxycycline capsules, to allow the capsule to move quickly into the stomach and prevent irritation of the throat or food pipe. 

Keep taking the Doxycycline until the full course is finished (unless a doctor tells you to stop), even if you feel that the infection has cleared up as it may return. If you forget to take a dose, take one as soon as you remember unless it's nearly time for your next dose. In this case, just leave out the missed dose and take your next dose as normal.

Supplements that interact 

Avoid indigestion remedies, or supplements containing iron, magnesium, or zinc at the same time as doxycycline (from 2 hours before to 2 hours after taking doxycycline) as they stop the antibiotic from working properly.

Never give your medication to other people even if their condition appears to be the same as yours.

Most types of medicines can cause potential side effects. However, not everyone will experience them. The side effects often improve as your body adjusts to the new medicine, but if any of them continue or become troublesome then contact us, or speak with your doctor or pharmacist.

Side effects include:

• photosensitivity
• diarrhoea
• abdominal symptoms: upset tummy, indigestion or abdominal pain
• headaches
• thrush
• dry mouth, throat irritation
• sweating or feeling anxious

Doxycycline may cause your skin to become more sensitive to sunlight than usual. Avoid strong sunlight and do not use sunbeds. Use a sun cream with a high sun protection factor on bright days, even when it is cloudy. If you develop skin redness then speak to your doctor or pharmacist as soon as possible. 

It is important that you tell your doctor in your assessment of all the medical conditions you have, and all the medications you take. Failure to do so can lead to problems with any treatment you are prescribed. Always read the patient leaflet before you take any medication. 

The following groups of people should not take Doxycycline:

• breastfeeding
• pregnant women
• children
• those with rare hereditary problems of fructose intolerance, glucose-galactose malabsorption or sucrose-isomaltase insufficiency

The following medications can interact with Doxycycline (see the patient information for the full list):

• methotrexate
• warfarin
• ergotamine
• retinoids
• oral contraceptive pill

An itchy rash, swollen face or mouth, or difficulty in breathing, may be signs that you are allergic to the medication. 

Please note that i-GP DOES NOT TREAT Medical Emergencies. 

If you develop a sudden onset of any of the symptoms below then you must STOP the medication immediately and seek urgent medical advice. This could be from your GP, Out of Hours Service, Urgent Care Centre or NHS 111. Call an ambulance or go to A&E if the symptoms are severe.

• Wheeze
• Difficulty in Breathing
• Swelling of the eyelids, face or lips
• A rash particularly if affecting your entire body

The following tests can be done to confirm the diagnosis, which includes either a urine test (FCU)* or a swab. ^3,5  

You can be tested at (or obtain free and confidential chlamydia self-testing kits from):

• your GP practice
• a local GUM (sexual health) clinic
• contraceptive clinic

You can also buy chlamydia testing kits from your pharmacy.

A test of cure after treatment is not usually necessary, except in pregnant women.¹ Repeat testing is advisable after 3-6 months to check for re-infection especially in those under the age of 25, and who are at high risk of re-infection.¹

*(FCU)- first-catch urine sample. Do not empty your bladder for at least 1 hour before the test, then catch the first sample of urine you pass from your bladder.

If left untreated then the infection may spread and cause problems in other parts of the body, leading to long-term health problems. This is why you should consider regular testing and ensure you are treated quickly.

Women

Pelvic Inflammatory disease (PID)  occurs in 16% of women with untreated chlamydia. PID can increase the risk of infertility, ectopic pregnancy, and chronic pelvic pain. Women with one episode PID may cause tubal infertility in up to 18% of those, affected, as suggested in one review.⁹

Men

Epididymo-orchitis (pain and inflammation of the epididymis and testes). Some studies suggest a possible association with male infertility, but the evidence for this is not conclusive.^10,11

In males and females

Chlamydia can also cause sexually acquired reactive arthritis. It can affect about 1% of men but is rare in women. 

Chlamydia can infect the eyes causing conjunctivitis which can cause eye redness, pain, and discharge.

It can infect the rectum (with unprotected anal sex) leading to discomfort and discharge from your rectum.

Chlamydia in pregnancy 

There is a greater risk of premature rupture of membranes and a low birth weight if a woman has chlamydia during pregnancy. There is also a risk of the baby developing chlamydia conjunctivitis if the infection is left untreated.

Please use the following links to find your nearest Sexual Health/ GUM clinic.

• England
• Wales
• Scotland
• Northern Ireland

You can call the national sexual health helpline free on 0300 123 7123 for further advice if you are worried.

SH:24 is a free online sexual health service, delivered in partnership with the NHS. They provide free test kits, information and advice - 24 hours a day.

What is abuse?

Abuse is anything another person does that's meant to cause harm. But it's not always easy to know what's abuse or what to do about it. 

There are many types of abuse from physical, emotional, sexual, neglect or domestic. Abuse is always wrong and must be stopped. It is important to take the first step and seek help. If you are in immediate danger call 999.

You can find out more about the types of abuse and where you can access help on the YoungMinds Website.

Domestic violence and abuse

If you are experiencing domestic violence or know of someone that may be experiencing abuse that may need help or support then you can contact the following 

• National Domestic Violence Helpline Free 24-hours a day on 0808 2000 247 Run in partnership between Women's Aid and Refuge.
• Men's Advice Line: confidential helpline for men experiencing domestic violence from a partner or ex-partner (or from other family members). Call freephone 0808 801 0327 Monday-Friday 9am-5pm

Help after rape or sexual assault

Please see the NHS website for further information.

• In an emergency call 999
• You can contact the non-emergency police number 101
• Or call NHS 111 for further advice

For specialist medical attention and sexual violence support, you would need to be seen at a sexual assault referral centre (SARC). You can find your nearest one here.

Childline

Childline is there to help anyone under 19 in the UK with any issue they’re going through. Whether it’s something big or small, or are worried that you may be going through abuse, their trained counsellors are there to support you.

Childline is free, confidential and available any time, day or night. You can talk to them:

• by calling 0800 1111
• by email
• through a 121 Webchat
  

If you are worried about a child, don't wait until you are certain. If you have any concerns or suspicions, contact the NSPCC free helpline service to speak to an NSPCC counsellor 24/7 or report your concern online here.

If you think a child is in immediate danger don't delay – call the police on 999.

Modern Slavery Helpline

If you think you are a victim of modern slavery/human trafficking contact the modern slavery helpline. They can help you to understand what is available including information, advice and, ways to access government-funded support. The Modern Slavery Helpline is confidential, but, if you don't want to give your name, that is fine. Find out more here.

Call free 24/7 on 08000 121 700 to get help, report a suspicion or seek advice. 

Female genital mutilation (FGM)

FGM is abuse and illegal under the UK law. All girls and women have the right to a life free from pain, period problems and difficulties with childbirth that are caused by female genital mutilation.

Female genital mutilation, female circumcision or ‘cutting’ may cause serious health and emotional consequences that last a lifetime. You can stop it. For advice, support or to report it, call the free 24-hour anonymous FGM helpline on 0800 028 3550. Find out more about it here.

Protecting young people from sexual

exploitation

It is important that young people are kept safe from sexual exploitation. Child sexual exploitation doesn't always involve physical contact and can happen online. It can be stopped and it is everyone's responsibility to report any concerns.

Child sexual exploitation is a hidden crime and can be difficult to identify. Young people often trust their abuser and don't understand that they're being abused. They may depend on their abuser or be too scared to tell anyone what's happening. You can find out more about here.

If you are worried about a child then contact the NSPCC trained helpline counsellors for 24/7 help, advice and support on 0808 800 5000 or email help@nspcc.org.uk

Watch the NSPCC video sharing the story of a young person who has been groomed and sexually exploited.

1. NICE CKS: Chlamydia - uncomplicated genital June 2006

2. Public Health England PHE, 2015

3. British Association for Sexual Health and HIV (BASHH) 2015 UK national guideline for the management of infection with Chlamydia trachomatis, [BASHH, 2015] 

4. Scottish Intercollegiate Guidelines Network (SIGN) guideline Management of genital Chlamydia trachomatis infection [SIGN, 2009].

5. Royal College of General Practitioners (RCGP) guideline Sexually Transmitted Infections in Primary Care [RCGP, 2013]. 

6. Health Protection Agency guideline on Diagnosis of Chlamydia trachomatis, Quick Reference Guide for General Practices [HPA, 2008].

7. BNF 71 (2016) British National Formulary.

8. Schembri G, Schober P. Risk factors for chlamydial infection in chlamydia contacts: a questionnaire-based study.  J Fam Plann Reprod Health Care 2011; 37(1): 10-16.

9. Haggerty CL, Gottlieb SL, Taylor BD et al. Risk of sequelae after Chlamydia trachomatis genital infection in women. J Infect Dis 2010 Jun 15; 201 Suppl 2: S134-55.

10. Bezold G, Politch JA, Kiviat NB, et al. Prevalence of sexually transmissible pathogens in semen from asymptomatic male infertility patients with and without leukocytospermia. Fertil Steril 2007; 87: 1087–1097.

11. Joki-Korpela P, Sahrakorpi N, Halttunen M, et al. The role of Chlamydia trachomatis infection in male infertility. Fertil Steril 2009; 91(4 Suppl): 1448–1450.

12. Lau Cy, Qureshi AK. Azithromycin versus doxycycline for genital chlamydial infections: a meta-analysis of randomized clinical trials. Sex Transm Dis 2002;29(9):497-502.