Chlaymdia

Question 1

What is partner concordance for c4?

Answer 1

75%

Question 2

What is chlamydia?

Answer 2

Obligate intracellular bacterium

Commonest in UK.

Question 3

What % people spontaneously clear c4?

Answer 3

50% 12 mths

Question 4

What is first line management uncomplicated including rectal? (Not pregnant)

Answer 4

100mg bd 7/7

TOC if rectal

Question 5

What is first line if tetracycline allergy or pregnant?

Answer 5

Azithromycin 1g, 500, 500

Pregnant-TOC

Question 6

Is there an issue with azithromycin in pregnancy?

Answer 6

Not really. A case control study showed association (not correlation) with azithromycin and miscarriage. However untreated infection poses risk too.

Study could not conclude whether better to treat or not treat it or….causality.

As azithromycin better tolerated and more effective than erythromycin/amoxicillin bashh do not suggest need to avoid.

Question 7

What is look back period for symptomatic male urethral c4?

Answer 7

4/52

Question 8

Look back for all women, all asymptomatic men, all non urethral symptomatic men….

Answer 8

6/12

Question 9

How long to abstain post treatment?

Answer 9

1 week (=on completion of doxy) will be 4/7 after AZT completed

Question 10

Diagnosis?

Answer 10

NAAT VVS (96-98% sensitive) or FVU (hold 1hr 1st 20ml)

Rectal

If proctitis (m/f) -LGV

If positive c4 any site MSM HIV-LGV

Repeat if in window period (2/52)

Question 11

What other abx could you consider (first line doxycycline….AZT)

Answer 11

Erythromycin less effective SE
Ofloxacin SE

No doxy/oflox pregnancy

Question 12

If TOC when?

Answer 12

> 3 weeks

Question 13

If under 25 don’t forget

Answer 13

Test for reinfection 3-6/12

Question 14

Conjunctivitis neonate when?
Pneumonia?

Answer 14

5-12 days but consider 0-30
1-3 mth pneumonia

Treat erythromycin