Chlamydia is usually treated with antibiotics your GP prescribes. In practice that is often doxycycline for seven days, and in some situations a single dose of azithromycin. Which course and dose fits you is decided by your doctor. After a proper course the infection clears in most people.
The reassuring thing about chlamydia is this: the treatment is simple and well studied. The biggest gain is in testing in time, not in the course itself.
Which antibiotics are used for chlamydia?
For chlamydia two antibiotics are usually used: doxycycline and azithromycin. Doxycycline is typically taken for a week, azithromycin sometimes as a single dose. Which choice fits you depends on your situation, such as a possible pregnancy or an infection in the anus. Your GP decides that.
Research underpins the choice. In a randomised study (Geisler et al., New England Journal of Medicine, 2015) cure with doxycycline was slightly higher than with azithromycin. A meta-analysis (Kong et al., Clinical Infectious Diseases, 2014) saw a comparable difference, especially with an infection in the anus.
The table below compares the two in outline. It is information, not a prescription; your doctor chooses what fits.
| Antibiotic | How often | Points to note |
|---|---|---|
| Doxycycline | Usually a week, twice a day | Not during pregnancy; can make skin more sun-sensitive |
| Azithromycin | Often a single dose | Handy for adherence; sometimes slightly less effective for anal infection |
The choice and dose belong with your GP. Thuisarts.nl describes that chlamydia is well treatable with antibiotics, and the NHG guideline on the STI consult starts from the same principle.
How fast does treatment work?
After starting the antibiotics the treatment begins working straight away, but the bacteria do not vanish instantly. Doctors usually assume you are no longer infectious about seven days after a single dose, or after finishing a week-long course. Complaints can still linger a little in that period.
Always finish the course, even if you feel better sooner.
If you recently got a positive result and are unsure what to do, read a positive STI result: what now. The full overview is on our hub about chlamydia.
What to watch during the course?
Wait with unprotected sex until you and your partner have finished treatment, usually about a week. Otherwise you can reinfect each other, the so-called ping-pong infection. Have recent partners checked too, whether or not they have complaints.
This is exactly where most reinfections start: a partner who was not treated alongside you.
How to discuss this calmly is in notifying your partner after a positive STI test. More about the possible risks of delay is in chlamydia risks and infertility.
Is a retest after treatment needed?
A standard check test to prove the course worked is usually not needed for a routine chlamydia infection. A retest can be useful if you were exposed again, or to catch a reinfection later. A PCR test can still pick up dead bacterial material shortly after the course, so testing again very early often has little point.
What fits your situation is something you discuss with your GP. More on this is in chlamydia retest and follow-up. If you want to check again, you can do so anonymously with a chlamydia test or a test for chlamydia, gonorrhoea and trichomonas.
Frequently asked questions about chlamydia treatment
How long does chlamydia treatment take? Usually a week with doxycycline, or a single dose with azithromycin. Which course fits you is decided by your GP.
When am I no longer infectious after the course? Doctors usually assume about seven days after a single dose or after finishing a week-long course. Wait until then with unprotected sex.
Can I drink alcohol during the course? With doxycycline and azithromycin a single glass is usually no problem, but ask your GP or pharmacist if in doubt.
Do my complaints go away straight away? Not always. Complaints can linger a little while the infection is already clearing. If they persist, talk to your GP.
Does my partner need treatment too? Yes, that is usually advised, even without complaints. That way you avoid reinfecting each other.
Every STI result we provide is assessed by a BIG-registered doctor. Decisions about medication and dosing belong with your GP; this article is meant as explanation, not as medical advice.
Sources
- Thuisarts.nl, I may have chlamydia
- NHG, Dutch College of General Practitioners
- Geisler WM et al. Azithromycin versus doxycycline for urogenital Chlamydia trachomatis infection. N Engl J Med. 2015 (PMID 26699167).
- Kong FY et al. Azithromycin versus doxycycline for the treatment of genital chlamydia infection. Clin Infect Dis. 2014 (PMID 24729507).
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