Dr Kola Tytler MBBS CertHE MBA MRCGPClinical Lead • iatroX
Management of a pregnant patient diagnosed with Chlamydia:
- Refer the patient to a genito-urinary medicine (GUM) clinic for specialist management if possible. If the patient declines or cannot attend, manage in primary care with appropriate antibiotic treatment after discussion with the woman's midwife, obstetrician, and GUM specialists.
- Treatment options for pregnant women include:
- Azithromycin 1 g orally as a single dose on day 1, followed by 500 mg orally once daily for 2 days,
- Erythromycin 500 mg four times daily for 7 days or 500 mg twice daily for 14 days, or
- Amoxicillin 500 mg three times daily for 7 days.
- Advise the patient that sexual intercourse (including oral sex) should be avoided until she and her partner(s) have completed treatment to prevent reinfection and onward transmission.
- Strongly encourage partner notification and treatment to reduce the risk of reinfection.
- Arrange a test of cure at least 3 weeks after completion of treatment, as it is indicated in pregnancy to confirm eradication of infection.
- Offer screening for other sexually transmitted infections (STIs) including gonorrhoea, HIV, hepatitis B, and syphilis.
- If there is any uncertainty about treatment or complications, seek specialist advice promptly.