Management of Uncomplicated Chlamydia trachomatis Infections in Adolescents and Adults: Evidence Reviewed for the 2006 Centers for Disease Control and Prevention Sexually Transmitted Diseases Treatment Guidelines

In April 2005, in preparation for the 2006 Centers for Disease Control and Prevention (CDC) sexually transmitted diseases (STD) treatment guidelines, the CDC convened an advisory group to examine recent abstracts and published literature addressing management of Chlamydia trachomatis infections in adolescents and adults. Key questions were posed and answered on the basis of quality of evidence and expert opinion. Clinical trials continue to demonstrate equivalent efficacy and tolerability of azithromycin and doxycycline regimens, and both remain recommended as first-line therapy in nonpregnant individuals. More data and clinical experience are available to support the efficacy, safety, and tolerability of azithromycin in pregnant women, and, in the upcoming guidelines, azithromycin will be recommended as first-line therapy for such patients. Evidence is building that expedited partner therapy (EPT), with provision of treatment or a prescription, may be just as effective as or more effective than standard partner referral in ensuring partner treatment and preventing chlamydia recurrence in women. Although there are more studies needed and barriers to be addressed before its widespread use, EPT will be recommended as an option for partner management.