**6. Treatment of urogenital** *C. trachomatis* **infection**

The treatment of *C. trachomatis* infection is exactly related to the localization of the infection, the age of the patient, and if the infection is complicated or noncomplicated. Additionally, the treatment of pregnant women differs from than of nonpregnant individuals.

For noncomplicated *C. trachomatis* infection cases; orally single doses of 1 g azithromycin or 100 mg doxycycline orally twice per day for 7 days are recommended. It has been reported that these treatment modalities have similar efficacy rates and

#### Chlamydia trachomatis *Infection in Women DOI: http://dx.doi.org/10.5772/intechopen.111755*

adverse events profiles [13]. According to recent guidelines patients with urethritis need to be followed up if symptoms persist or in the presence of recurrence. In the case of a recurrence or persistent urethritis, treatment with 2 g metronidazole in a single dose combined with 500 mg erythromycin four times per day for 7 days, or 800 mg erythromycin orally four times per day for 7 days is recommended [13]. Importantly patients should be informed that they need to abstain from sexual intercourse for 7 days after starting the treatment. Of note, both patients and their sexual partners must be treated simultaneously.

While routine repeat testing for chlamydia after any treatment is not recommended, in pregnant cases or in patients with persisting symptoms, repeated test need to be performed. Because of the high rate of reinfection routine screening test need to be done 3 to 4 months after antibiotic treatment. The use of Postal testing kits PTK (partners post urine for testing) or patient-delivered partner therapy (PDPT) has been considered as novel intervention to reduce reinfection in women with chlamydia infection. In a controlled study, it has been described that these techniques do not reduce reinfection rates in women with chlamydia infection when compared with patient referral [20].

In PID cases treatment can be performed in a outpatient setting. However, in pregnant cases, in patients with severe illness, nausea or vomiting, in the presence of high fever concomitant with tuba-ovarian abscess hospitalization is mandatory. Additionally, hospitalization is indicated if there is a possibility of surgical emergencies. In patients who are unable to tolerate oral treatment regimens need also followed up on an inpatient basis.

Pregnant cases should not be treated with doxycycline and ofloxacin because their use is contradicted during pregnancy. Instead of these agents, erythromycin or amoxicillin should be the choice of treatment for chlamydia infection in pregnant women [13].
