Ophthalmologic Manifestations of Chlamydia Treatment & Management

Updated: Oct 04, 2018
  • Author: Mounir Bashour, MD, PhD, CM, FRCSC, FACS; Chief Editor: Hampton Roy, Sr, MD  more...
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Treatment

Medical Care

Simultaneous treatment of all sexual partners is important to prevent reinfection. It also is prudent to examine all sexual partners for other venereal diseases, such as gonorrhea, syphilis, and HIV. It may also be wise to treat all members of the household with antibiotics. [6]

Treatment consists of systemic antibiotics; topical antibiotics are relatively ineffective in the treatment of this eye disease. Recommended treatment, which is given for 3-6 weeks, includes oral tetracycline (500 mg qid), oral doxycycline (100 mg bid), or oral erythromycin stearate (500 mg qid). Azithromycin can be given as a single dose of 1 g, which can be increased to 2 g if Neisseria gonorrhoeae is suspected. Tetracyclines are avoided in children younger than 7 years and in women who are pregnant or breastfeeding.

Conclusions from a 2013 study show single-dose azithromycin should be considered as reliable as long-term alternative regimens for adult inclusion conjunctivitis. Patients should wait for one week until the first signs of significant regression become obvious and should consider approximately one month to total relief. Follicles could be reasonably used as a key sign for clinical assessment of treatment success. [7]

Also see the clinical guideline summary, Conjunctivitis, from the American Academy of Ophthalmology, [8] and one from the US Preventive Services Task Force, Behavioral counseling to prevent sexually transmitted infections: U.S. Preventive Services Task Force recommendation statement. [9]

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Consultations

Infectious disease specialist or sexually transmitted disease clinic as necessary

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Activity

No sexual activity until the course of treatment is complete.

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Prevention

Patients should follow safe sexual practices, including the use of condoms.

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Long-Term Monitoring

Patients should be observed 2-6 weeks after initiation of treatment, depending on the severity of the initial symptoms.

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