Internal Medicine

Treatment of a chlamydial infection

introduction

Chlamydial infections are common. The transmission takes place through sexual intercourse.
Chlamydial infections often do not cause any symptoms. However, detection and treatment of the chlamydial infection is very important, as it can lead to serious consequences such as infertility.

Chlamydia are bacteria. Therefore, antibiotics are used for treatment. As a rule, the treatment is straightforward and taking antibiotics for a certain period of time is completely sufficient.

These treatments are available:

Antibiotic therapy
Partner treatment

These antibiotics are there

Since chlamydia, unlike many other bacteria, live inside human cells, many antibiotics, such as B. Penicillins, not effective. Certain antibiotics must be used for treatment.

Doxycycline, which belongs to the group of tetracyclines, is used as standard in therapy.
A frequently used alternative are antibiotics from the group of macrolides. Erythromycin and Azythromycin are primarily used here.
In addition, antibiotics from the quinolone group are also effective against chlamydia. The quinolones include levofloxacin and ofloxacin.

Resistance to certain antibiotics has developed in many bacteria. Fortunately, chlamydia resistance to antibiotics has not yet developed.

For more information, read on: Antibiotic therapy for chlamydia.

Duration of antibiotic administration

The duration of the antibiotic administration depends on the respective antibiotic:

The doxycycline, which is usually prescribed, has to be taken twice a day - once in the morning and once in the evening.
Doxycycline must be taken over a period of one week.
Azythromycin with 1.5 g of active ingredient, on the other hand, only needs to be taken once, as it is broken down by the body much more slowly.
If azythromycin 500mg is prescribed, it must be taken once a day for 3 days.
Erythromcyin 500mg is taken four times a day for 7 days.
Levofloxacin and ofloxacin also need to be taken for over a week each, with ofloxacin 300mg twice daily while levofloxacin 500mg only needs to be taken once daily.

The intake times mentioned above refer to normal chlamydial infections.
In the case of more complicated courses, antibiotics may be necessary for a significantly longer period of time.

Can you treat the infection without antibiotics?

An antibiotic must be used for effective chlamydia treatment, as this specifically attacks the bacteria.
Also because of the severe consequences that can result from a chlamydial infection, effective therapy with an antibiotic should be used.

According to the current state of science, there is unfortunately no known effective alternative to antibiotics with which a chlamydial infection can be successfully treated.
After therapy, it is important to avoid re-infection with chlamydia. It is recommended to wear condoms, especially if you frequently change sex partners.

Please also read the article: Put the condom on properly

After taking antibiotics, the vaginal flora can be rejuvenated so that it recovers.
Numerous different products are offered here.

When do you do a follow-up check?

The follow-up check does not take place until six weeks after taking the antibiotics.

A sensible check can unfortunately only be carried out so late, since the chlamydial RNA is detected during the check. However, the RNA can still be detected over a longer period of time after successful therapy, since components of the chlamydia can still be on the genital skin for several weeks.
After six weeks it can be assumed that the last bacterial components have disappeared.

The follow-up check is usually carried out using urine, which is given to the doctor in attendance and sent by him to the laboratory.

Also read the article: The chlamydia test.

What to do if you still have symptoms after chlamydia treatment?

Unfortunately, there are often relapses (so-called relapses) or renewed infections, which can be a cause of the persistent symptoms.
In this case it is necessary to take antibiotics again.
In some cases, an antibiotic must be taken several times in a row to successfully treat chlamydial infection. However, you shouldn't be treated any further on your own.

In any case, if the symptoms persist, a doctor should be consulted again.
They can then recommend further treatment and clarify whether there are other causes for the symptoms.

Taking antibiotics messes up the entire flora of the vagina, which can then lead to other problems.
Fungal infections are not uncommon after chlamydia treatment.

Do you think you may have a vaginal yeast infection?

Vaginal fungus can be recognized by these symptoms: Symptoms of vaginal thrush

Partner treatment - what is it?

Since it is a sexually transmitted infection, the partner should also be treated. Otherwise it can lead to a so-called ping pong effect. This means that the partners keep infecting each other. If the partner is also treated, this ping-pong effect is prevented. Treatment of the partner should be done at the same time.

During therapy, i.e. taking antibiotics, sexual intercourse should be avoided.
Although the use of condoms significantly reduces the risk of infection, transmission cannot be 100% excluded.
Under no circumstances should unprotected intercourse take place during treatment.

Read our article on this: Chlamydia in men

Treatment cost

As a rule, the treatment of an uncomplicated chlamydial infection only incurs the costs for the antibiotic, the doctor's visit and the laboratory examination in which the chlamydia was diagnosed and the one in which the follow-up is carried out.
In the case of complicated infection processes, there are additional costs.

However, the costs of the treatment are covered by the health insurance.
The cost of a laboratory test for chlamydia varies depending on the doctor and is at least € 50.
In the pharmacy or in the online shop, much cheaper rapid tests for at home are also available.

Does the health insurance company cover the costs?

The health insurance company pays for the treatment.

Only the prescription fees of 5 to 10 € for the antibiotic prescription have to be borne by the legally insured.

As a preventive measure, there is a screening in order to be able to determine a possible Chlamyia infection in sexually active women.
The screening is offered to women under the age of 25 once a year and is covered by the health insurance company, provided the examination is carried out through the urine.
Older women have to pay for the test themselves - unless the doctor suspects a chlamydial infection.

How long will you be contagious after the treatment?

After the end of the therapy you are no longer contagious, provided that it was successful.

At the latest after the negative follow-up check you can be sure that you are no longer contagious. But even before that, you are no longer contagious after taking antibiotics, as all bacteria have been killed after this.

Unprotected sexual intercourse should be waited until after antibiotic use has been completed.

How to treat chlamydial infection during pregnancy

Treatment options for chlamydial infection during pregnancy are more limited, as many antibiotics cannot be given during pregnancy.

However, therapy should be given before birth, as otherwise it can be transmitted to the child during birth.
In children, the infection manifests itself as an inflammation of the eyes, in some cases also as an otitis media. The doxycycline, which is used as standard for chlamydial infections, must no longer be used from the 2nd trimester, since the teeth of the unborn children can turn yellow when taken. Furthermore, doxycycline may reduce bone growth and increase the susceptibility to tooth decay.

Therefore, pregnant women are usually prescribed azytrhromycin to treat chlamydial infection.
Alternatively, erythromycin can also be used.
Preventive screening for chlamydia in pregnant women takes place in Germany in order to avert possible consequences for mother and child through early therapy.

Read more about the topic here: Chlamydial infection during childbirth

This is how you treat pain

Many women have no symptoms during a chlamydial infection. However, if there are symptoms such as pain, these should definitely be addressed to the doctor. In addition to the antibiotic, he or she can also prescribe a pain reliever or advise on what can still be done to relieve pain.

Pain can indicate a more complicated course of the infection so that the doctor can clarify more precisely whether there are any complications.
A possible complication would be the spread of the infection to the uterus and ovaries.