Tracking down chlamydia infection in primary care.

Chlamydia is the most commonly diagnosed bacterial STI in this country. Sexually active people under 20 are the group most likely to have a positive result if tested. Infection is usually asymptomatic. Transmission occurs through vaginal, rectal or oral sex. Early detection and treatment can prevent transmission. Untreated chlamydia infection can result in complications such as PID, sexually acquired reactive arthritis and epididymo-orchitis. Sexually active individuals with symptoms or signs suggestive of chlamydia infection and people in certain risk groups or in circumstances where it is particularly important to make the diagnosis should be offered testing. These include: sexual partners of chlamydia patients; individuals diagnosed with chlamydia in the past 12 months; people with two or more partners in the past two months; all women undergoing termination of pregnancy; people under 25 who are sexually active and sexual health clinic attendees. All patients with chlamydia and their sexual partners should be advised to abstain from sexual contact until treatment has been completed. Sexual contacts should be notified and partner notification should be offered to all patients with chlamydia regardless of where they were diagnosed. All contacts should be offered a test for chlamydia and advised to take treatment (1g azithromycin) without waiting for results. Patients should be followed up two to four weeks after treatment.