Chlamydia (C4)

Question 1

What is the transmission rate in partners? (C4)

Answer 1

75%

Question 2

What is spont resolution rate of c4? Over how long?

Answer 2

50% over 1yr

Question 3

Sx of conjunctival c4?
Rectal?
Pharynx?

Answer 3

Conjunctiva- low grade red eye, often unilateral
Rectal- usually none but can be pain or d/c
Pharynx-often none

Question 4

Treatment for uncomplicated c4?

If pregnant or bf’ing?

Answer 4

Doxy 100mg bd for 7d
(NOT IF PREGNANT)
Or azithro 1g then 500mg od for 2d

Or if both contraindicated
Erythro 500mg bd for up to 2w
Or
Oflox 200mg bd for 7d

If preg/bf’ing: NO DOXY OR OFLOX
give extended azithro, or erythromycin as above, or Amox 500mg TDS for 7d

Question 5

TOC for c4?

When and in who?

Answer 5

6w ONLY if preg/ poor compliance suspected/ sx persisting and rectal infections

Question 6

Coinfection rates of MGen with known C4?

Which Abx have increasing resistance to MGen?

What site of C4 does azithro not treat well?

Answer 6

3-15%

Increasing MGen resistance in macrolides (azithro, erythro)

Rectal C4 doesn’t respond well to azitrho as single dose

Question 7

Lookback periods:
Asymp
Symp males

Answer 7

Asymp 6/12

Symp men 1/12

Question 8

Neonatal C4 infection

Common sites, incubation periods for each, testing and treatment

Answer 8

Conjunctivitis (ophthalmia neonatorum)
Appears within 2w usually, NAAT swab but not validated.

Pneumonia, within 1-3months, nasopharyngeal NAAT,

All treat with ORAL erythromycin

Question 9

PN OF C4 ?

Answer 9

Guidelines just say test contacts, don’t actually say to treat them!?