TreatmentTreating persons infected withC. trachomatispreventsadverse reproductive health complications and continuedsexual transmission, and treating their sex partners can preventreinfection and infection of other partners. Treating pregnantwomen usually prevents transmission ofC. trachomatistoneonates during birth. Chlamydia treatment should beprovided promptly for all persons testing positive for infection;treatment delays have been associated with complications (e.g.,PID) in a limited proportion of women (513).Recommended RegimensAzithromycin1 g orally in a single doseORDoxycycline100 mg orally twice a day for 7 daysAlternative RegimensErythromycinbase 500 mg orally four times a day for 7 daysORErythromycin ethylsuccinate800 mg orally four times a day for 7 daysORLevofloxacin500 mg orally once daily for 7 daysOROfloxacin300 mg orally twice a day for 7 daysA meta-analysis of 12 randomized clinical trials ofazithromycin versus doxycycline for the treatment of urogenitalchlamydial infection demonstrated that the treatments wereequally efficacious, with microbial cure rates of 97% and 98%,respectively (514). These studies were conducted primarilyin populations with urethral and cervical infection in whichfollow-up was encouraged, adherence to a 7-day regimen waseffective, and culture or EIA (rather than the more sensitiveNAAT) was used for determining microbiological outcome.More recent retrospective studies have raised concern aboutthe efficacy of azithromycin for rectalC. trachomatisinfection(515,516), however, these studies have limitations, andprospective clinical trials comparing azithromycin versusdoxycycline regimens for rectalC. trachomatisinfectionare needed.Although the clinical significance of oropharyngealC. trachomatisinfection is unclear and routine oropharyngealscreening for CT is not recommended, available evidencesuggests oropharyngealC. trachomatiscan be sexuallytransmitted to genital sites (152,517); therefore, detectionofC. trachomatisfrom an oropharyngeal specimen shouldbe treated with azithromycin or doxycycline. The efficacy ofalternative antimicrobial regimens in resolving oropharyngealchlamydia remains unknown.