**3. Problems of therapy of chlamydia infection**

Research in recent years recommends that in the treatment of chronic inflammatory diseases of the genitals, efforts should be directed toward the elimination of pathogens instead of the classical empirical prescription of broad-spectrum antibiotics [8]. This is especially true for chlamydial infections. Analysis of the problems of diagnosis of chlamydia infection clearly shows that the prevalence of chlamydia infection, especially chronic persistent forms of it, is much wider than the results of the NAAT examination show. This is reflected in the choice of therapy and its results. Patients with chronic inflammatory diseases of the genital area and undiagnosed chlamydia infection either do not receive therapy or receive insufficiently adequate therapy. The use of broad-spectrum antibiotics capable of penetrating cells in the treatment of such cases to a certain extent makes it possible to compensate for diagnostic deficiencies. However, antibiotic therapy is not sufficiently effective in cases of persistent forms of chlamydia. Other factors are also important.

Chlamydiosis is a sexually transmitted disease. It requires the treatment of both partners, the use of protection during sexual intercourse until both partners are tested negative for chlamydia. There are no such requirements for the treatment of genital inflammatory processes caused presumably by viruses and opportunistic microorganisms. In undiagnosed chlamydial infections, renewed sexual contact with a previous partner or partners leads to reinfection after therapy.

#### *Organizational and Socio-Psychological Difficulties of Management of Patients with Chlamydia… DOI: http://dx.doi.org/10.5772/intechopen.109748*

Another problem of chlamydia therapy is associated with the tendency to unify therapeutic approaches without taking into account the topical diagnosis, and pathoanatomic and clinical features of the course of the disease. The Clinical Guidelines for the treatment of chlamydia indicates the sufficiency of prescribing 1 g of azithromycin once or 200 mg of doxycycline for 7–10 days. The efficacy of such therapy in a long-standing chlamydial process with chronic inflammation and fibrosis is unlikely, and diagnostic problems often do not allow this to be seen.

Analysis of the clinical studies shows that researchers pay little attention to the comparison of the choice of an antibacterial drug, the duration and regimen of its administration, and the possibility of reinfection in the treatment of chlamydial infection [9]. The difficulties of such a comparative analysis can be explained not only by the different clinical course of chlamydial infections, but also by various socio-psychological factors.

The sexually transmissible nature of chlamydial infections dictates that sexual partners must be examined and treated. Examination of partners is necessary regardless of the presence or absence of complaints and clinical symptoms. It is optimal not only to try to identify the pathogen, but also to clarify the clinical form, the presence of structural changes, and assess the duration of persistence of the infection. This is necessary for the correct choice of the duration and composition of therapy. Treatment of sexual partners is advisable even in cases where chlamydia is not detected ("contact therapy"). It is highly probable that in these cases there is a chronic ascending infection, a persistence of chlamydia, which requires more attention. Often, however, the partners are examined formally or not at all. They are given a short course of antibiotics without regard to the nature of the process. Such treatment "by contact" may not be effective enough. It does not eliminate the chronic infection, but rather turns it into a chronic form.
