A patient with discharge per vagina was evaluated and on endocervical biopsy Chlamydia was found. Treatment to be given in this case is:
Ans. is a, i.e. Azithromycin and contact tracingRef: Harrison 18th/ed, pl426; William's Gynae 1st/ed, p66; Current diagnosis and treatment of sexually transmitted diseases p 81Management of ChlamydiaUncomplicated chlamydia can be treated with Tetracycline (500mg 4 times daily), Doxycycline (1000mg twice daily), Erythromycin (500mg 4 times daily), Fluoroquinolone -ofloxacin 300mg twice daily, or Azithromycin -single dose - 1gDrug of choice is Azithromycin lg single dose.Advantages of Azithromycin are* Single dose regimen - 1g stat dose (It is as effective as 7 days of doxycycline treatment).* Better patient compliance.* Fewer gastrointestinal side effects.Disadvantage:* High cost of azithromycin.Contact tracing:* Patients with asymptomatic infection and their sex partners form a major burden of chlamydial infection so, contact tracing should always be done (wherever possible).Alternative to azithromycin is doxycycline 100mg orally twice a day for 7 days.
Azithromycin and contact tracing
Metronidazole only
Doxycycline and metronidazole
Azithromycin
Sexually Transmitted Disease in the Female