guidelines and other important factors that the

such as a new sexual partner are present.

treating physician should consider are summa-

Screening tests that may be performed on an

rized in Table 25.5.

intraurethral swab in men or an endocervical

swab in women include: (1) nucleic acid amplifi-

Chlamydia

cation test (NAAT), (2) unamplified nucleic acid

hybridization test, an enzyme immunoassay

Diagnosis

(EIA), or direct fluorescent antibody (DFA), or

(3) culture.21 If the performance of a urethral or

Chlamydia is caused by Chlamydia trachomatis,

endocervical swab is not acceptable to the patient,

serotypes D through K. In 2009, it It was the most

NAAT may be performed on a urine specimen.

commonly reported disease to the CDC with over

1.2 million cases and is most prevalent in sexually

Treatment

active adolescents and young adults.1 The majority

Azithromycin 1 g by mouth as a single dose or

of both of men and women are asymptomatic. C.

trachomatis is the most common cause of

doxycycline 100 mg twice daily for 7 days are

epididymitis in young men. Men may also experi-

equally effective. Alternative therapies are listed

ence lower urinary-tract symptoms and notice a

in Table 25.5. Doxycycline, erythromycin esto-

clear or white urethral discharge. Forty percent of

late, levofloxacin, and ofloxacin are contraindi-

women with untreated infection will develop pelvic

cated during pregnancy. Erythromycin base,

inflammatory disease (PID) and scarring of the fal-

erythromycin ethylsuccinate, and azithromycin

lopian tubes.19

are safe during pregnancy. Another alternative

Selective screening has been shown to reduce

in pregnant women includes amoxicillin 500 mg

the incidence of PID.20 Women should be

three times per day for 7 days. Partners should

screened annually until age 25 or if risk factors

be examined, tested, and treated. Patients should