First line:

Doxycycline oral 100mg 12 hourly for 7 days

N.B. In pregnant patients, doxycycline is contraindicated.

Second line:

Azithromycin oral 1g as a single dose immediately, followed by 500mg daily for 2 days

N.B. Azithromycin should not be prescribed concurrently with ciclosporin, sirolimus or tacrolimus.

Third line:

For alternative treatment see WoS guidance on chlamydia (West of Scotland Sexual Health Managed Clinical Network guidelines) or refer to Sexual Health services.

• NICE provides a clinical knowledge summary on management of uncomplicated genital infections with C. trachomatis.
• Chlamydia is often asymptomatic, but can cause cervicitis in females and urethritis in males. Without treatment, 10-40% of infected women develop pelvic inflammatory disease (PID). In people with signs or symptoms strongly suggestive of PID start treatment without waiting for laboratory confirmation.
• Send nucleic acid amplification technique (NAAT) test for chlamydia if patients are sexually active with symptoms and signs suggesting chlamydia. Opportunistically screen all patients aged 16-24 years old. There is a lower cure rate in pregnancy, and testing for cure 3 weeks after completion of treatment is recommended.
• A full sexually-transmitted infection screen is advised, including HIV testing. All sexual partners should be offered, and encouraged to take up, full STI screening, including HIV testing and (if indicated) hepatitis B screening +/- vaccination. For advice or assistance with partner notification, please phone the Sexual Health Advisers on 01294 323228. 
• General advice: Patients should abstain from sexual intercourse (including oral sex) until they and their partner(s) have completed treatment (or wait 7 days if treated with azithromycin).