Primary prevention
Your Organizational Guidance
ebpracticenet urges you to prioritize the following organizational guidance:
Diagnose, behandeling, opvolging en doorverwijzing van infecties met Chlamydia trachomatis (CT) in de eerste lijnPublished by: Werkgroep Ontwikkeling Richtlijnen Eerste Lijn (Worel)Last published: 2025Diagnostic, traitement, suivi et renvoi des infections à Chlamydia trachomatis (CT) en soins primairesPublished by: Groupe de Travail Développement de recommmandations de première ligneLast published: 2025High-risk patients should be counseled on safer sex behaviors such as the use of condoms.[11]
Information should be collected on any person who has had sexual contact with a diagnosed patient within the previous 60 days, and the most recent sex partner should be evaluated and treated, even if the time of the last sexual contact was >60 days before symptom onset or diagnosis.[5] Counseling should be given about avoiding condomless sex, and the risk of reinfection with chlamydia and other sexually transmitted infections (STIs).[12] Screening for common coinfections such as Neisseria gonorrhoeae and Treponema pallidum should be routinely performed. Counseling and testing for HIV infection should also generally be done.[5]
In clinical trials, postexposure prophylaxis (PEP) with doxycycline has shown benefit in reducing the incidence of subsequent STIs (syphilis, chlamydia, and gonorrhea) in high-risk men who have sex with men (MSM) and transgender women (TGW).[13][14][15] On the basis of the observed efficacy of PEP with doxycycline for reducing the risk of STIs, Centers for Disease Control and Prevention (CDC) recommends that MSM and TGW who have had a syphilis, chlamydia, or gonorrhea infection within the previous 12 months should receive counseling that PEP with doxycycline can be used to prevent these infections.[16] PEP with doxycycline could also be discussed with men who have sex with men and transgender women who have not had a bacterial STI within the previous 12 months, but who are likely to participate in sexual activities that are known to be high risk for exposure to STIs.[16] PEP with doxycycline can be self-administered within 72 hours of sexual intercourse. Individuals prescribed PEP with doxycycline should undergo STI testing every 3-6 months.
Secondary prevention
Chlamydia infection retesting should take place 3 months after treatment to identify those who have been reinfected. Testing for a cure is generally not recommended except during pregnancy. In pregnant women, retest approximately 4 weeks after treatment, and again within 3 months.[5] The UK guidelines recommend a test of cure for rectal chlamydia at least 3 weeks after treatment.[2]
All sexual contacts within the past 60 days should be advised to seek investigation and treatment for chlamydia.
[ 
]
At the very least, the index case should notify sexual contacts that they may have been exposed to chlamydia. In some US states the law permits expedited partner therapy (EPT), which is the practice of treating the sex partners of persons with sexually transmitted infections (STIs) without an intervening medical evaluation or professional prevention counseling.[41]
CDC: expedited partner therapy
Opens in new window This may be considered as an option to facilitate partner management among heterosexual men and women with chlamydia infection. The American College of Obstetricians and Gynecologists has issued a statement supporting EPT in the management of chlamydial and gonorrhea infections when the partner is unlikely or unable to otherwise receive in-person evaluation and appropriate treatment.[42]
Use of this content is subject to our disclaimer