Antibiotics for Chlamydia: Understanding Treatment
Chlamydia is a sexually transmitted disease (STD) that affects both women and men. It is caused by a bacterial infection that is transmitted by having oral, anal, or vaginal sex with a person who already has chlamydia. Chlamydia is the most common sexually transmitted bacterial infection in the US, yet more than half of infected individuals exhibit no symptoms. Chlamydia rates continue to climb, too, with rates in California reaching the highest level on record in 2017. Chlamydia is curable, but requires antibiotics to clear the infection. Read more below to learn about specific treatment if you have chlamydia.
Recognizing the Symptoms of Chlamydia
It is common for someone with chlamydia to have no symptoms. In fact, 75% of women and 50% of men with chlamydia exhibit no symptoms. The key signs of chlamydia can appear within one week or up to three weeks after having sex with a person infected with chlamydia. Even with no symptoms, it is still possible to transmit the disease and damage the reproductive system.
There are some differences in how chlamydia presents in men vs women. In general, the most common reported symptoms in both men and women are:
- Chlamydia discharge – For women, this includes abnormal discharge from the vagina that may have a strong odor and be yellowish. For men, this can vary greatly, but may be cloudy or clear discharge around the tip of the penis.
- Burning sensation while urinating – Also called dysuria, this symptom is common with other STDs and is an important sign to get tested.
- Burning or itching around the vagina or penis – For women, this burning or itching may also be inside the vagina, and for men, this is usually around the penial opening.
Women can also have painful periods, bleeding between periods, pain during sex, abdominal pain, or a fever. Men can also have a less common symptom of swelling or pain in either or both testicles. Chlamydia can spread or infect the anus causing:
- Rectal pain
While rare, chlamydia can infect your eyes, causing itching, redness, or discharge, or your throat, causing soreness.
Diagnosing Your Chlamydia
Chlamydia can be diagnosed by several different laboratory tests. They can either use a urine sample to test for the bacteria or a cotton swab from the infected area. The chlamydia test most often uses a swab from the cervix for women and the urethra for men, but can also include a swab of the anus or other potentially infected areas. This swab is used for a culture or antigen for testing, both of which can identify if chlamydia is present. A doctor may also conduct a physical exam to examine symptoms and check for other STDs. Chlamydia and gonorrhea are very similar, so it is important to test for both to ensure you receive the right treatment. A doctor may ask:
- How often do you have unprotected sex?
- Do you have a new partner or multiple sexual partners?
- Do you exhibit any symptoms like discharge, pelvic pain, or pain when urinating?
These questions can be used to determine if you have a STD, and answering yes increases the likelihood that you may have contracted one. Getting tested for a STD can be scary and intimidating, but remember you are taking charge of your health. Seeking help can give you peace of mind knowing if you do or do not have a STD and what you can do about it.
Common Antibiotics Used for Chlamydia Treatment
Chlamydia is curable. Once you have been tested, your doctor can give prescribe chlamydia medicine, a course of oral antibiotics, for you. When taking antibiotics, your infected area and symptoms should improve within one or two days, but you may still be contagious. Make sure to take the full course of the chlamydia pills. The infection should clear after one to two weeks. You should never stop taking antibiotics until the recommended course is finished, even if you think the infection cleared or you are feeling better. If you do not finish the antibiotics, the infection can come back and be resistant to the antibiotics you were taking.
These common chlamydia antibiotics include:
- Amoxicillin – A broader spectrum form of penicillin, amoxicillin is a powerful antibiotic used for women who are breast-feeding, pregnant, or planning to become pregnant. Though not the most common treatment for chlamydia, it can be used for those who have allergies to other medicines.
- Azithromycin – Azithromycin is not related to penicillin and is the most common chlamydia medication. It is also less prone to producing gastrointestinal side effects than those in the penicillin family. Azithromycin for chlamydia is often given as 2 or 4 tablets to be taken as one dose. This medicine along with doxycycline cure up to 95% of cases of chlamydia.
- Doxycycline – This is the second most common antibiotic for chlamydia, but it should not be taken by women who are pregnant or planning to become pregnant as it can lead to birth defects. It is often given as two (2) tablets a day for a week. It also makes you more sensitive to sunlight, so you should take extra precautions to stay out of the sun and wear sunscreen if you are on this medication.
- Erythromycin – This antibiotic is only used as medicine for chlamydia for babies who have contracted the STD during birth from an infected mother.
- Levofloxacin or Ofloxacin – Both of these antibiotics should not be taken by women who are or planning to become pregnant. Similarly to doxycycline, they make you more sensitive to sunlight. These antibiotics are usually only used as medication for chlamydia when someone is resistant or allergic to other forms.
All of these medications should be prescribed by a doctor who understands your medical history and potential complications. For example, if a doctor believes you may be at risk for the infection to spread and cause further complications, the doctor may prescribe antibiotics for longer than the typical dosage. Common side effects with all of these treatment are usually mild, but can include feeling worn down, diarrhea, stomach pain, and vaginal thrush for women.
You and your sexual partner(s) should not have sex again until treatment is complete. You should wait at least one week after completing a prescribed single dose medication and finish all doses if you are prescribed a seven day treatment. In some cases, the infection may still be present, so you should wait until you and your partner(s) are sure the disease is no longer present.
Potential Chlamydia Complications
Because chlamydia often has no symptoms, some people go untreated. Even with those who have symptoms; stigma, access, or other reasons get in the way of getting medical attention. Not receiving prompt and proper treatment can create serious health problems. Chlamydia that goes untreated can increase the likelihood of contracting another STDs, like gonorrhea or HIV/AIDS, or increasing the likelihood of transmitting that STD to someone else. It is also possible to develop reactive arthritis, or arthritis caused by the body’s reaction to an infection, because of chlamydia. This can affect the joints, urethra, and eyes.
For women, chlamydia that goes untreated can spread through your uterus to your fallopian tubes. Fallopian tubes connect the ovaries to the uterus and transport fertilized eggs during pregnancy. If untreated chlamydia spreads to this area, the result is pelvic inflammatory disease (PID), affecting around 5% of women in the US.
Pelvic inflammatory disease, similar to chlamydia, can have no symptoms or just some pelvic or abdominal pain initially. Unfortunately, PID can do permanent damage to a women’s reproductive system, including:
- Long-term pelvic pain – PID can damage the fallopian tubes or other areas of the reproductive system inflaming them and causing chronic pelvic pain.
- Infertility – As the infection spreads through the fallopian tubes, the damage can cause scars that prevent any sperm from reaching an egg.
- Ectopic pregnancy – Sometimes, the sperm is able to get through and fertilize an egg, but the same damage and scarring can prevent the fertilized egg from reaching the uterus. This fertilized egg can implant in the fallopian tubes or elsewhere. Since these other areas are not designed to expand as the egg goes, they can rupture. This causes massive internal bleeding and even death. It is extremely important to call a doctor immediately if you experience any symptoms, such as heavy vaginal bleeding, dizziness, or shoulder pain.
- Premature birth – Even with the damage caused by the disease, it is still possible to conceive a child. Sometimes, PID can result in the birth occurring before the due date, which can risk the health and development of the child.
For men, chlamydia rarely leads to health problems. It is very rare for chlamydia to cause infertility in men, but sometimes the infection can spread past the penis causing fever or pain. In addition, it is possible for chlamydia to cause:
- Nongonococcal urethritis – This is an infection of the urethra, the tube that carries urine, which causes inflammation, pain, and fever.
Epididymitis – This occurs when the epididymis is infected, the tube beside the testicle that carries sperm, which causes inflammation, scrotal pain, and fever.
- Proctitis – This results in inflammation of the rectum.
- Prostate gland infection – This is an infection of the prostate gland, which can cause fever, pain during sex or while urinating, and pain in the lower back.
Should any of these symptoms arise, or if you suspect you may have a STD, it is very important to get tested. Even if you have no symptoms, as do the vast majority of those with chlamydia, you should be getting tested regularly so you do not unknowingly spread the disease. You can make an appointment with your primary care physician or see an urgent care to be tested.
Read more of our Chlamydia Series:
- Chlamydia Symptoms in Men and Women, Plus Proper Treatment
- Gonorrhea vs. Chlamydia: What’s the difference?
- Chlamydia Symptoms and Causes
- Chlamydia Test
- Centers for Disease Control and Prevention. Chlamydia – CDC Fact Sheet. Accessed September 20, 2019 at https://www.cdc.gov/std/chlamydia/stdfact-chlamydia.htm
- Medline Plus. Chlamydia Infections. Accessed September 20, 2019 at https://medlineplus.gov/chlamydiainfections.html
- Healthline. Everything You Need to Know About Chlamydia Infection. Accessed September 20, 2019 at https://www.healthline.com/health/std/chlamydia
- Drugs. Medications for Chlamydia Infection. Accessed September 20, 2019 at https://www.drugs.com/condition/chlamydia-infection.html