Bibliographic information
GuidelineUpdated recommendations for the treatment of Neisseria gonorrhoeae, Chlamydia trachomatis, and Treponema pallidum (syphilis) and new recommendations on syphilis testing and partner services.
Year of Publication2024
Issuing InstitutionWorld Health Organization
Recommendation
Updated
For adults and adolescents with uncomplicated chlamydial infections (genital, anorectal and/or oropharyngeal), WHO suggests:
- doxycycline 100 mg orally twice a day for 7 days.
If doxycycline is not available or adherence to multiple doses is a serious concern, WHO suggests:
- azithromycin 1 g orally as a single dose.
If doxycycline and azithromycin are not available, WHO suggests one of the following options:
- erythromycin 500 mg orally four times a day for 7 days;
- ofloxacin 200–400 mg orally twice a day for 7 days; or
- tetracycline 500 mg orally four times a day for 7 days
Recommended in favor
Conditional
Certainty of evidence
Moderate
Notes and Remarks
Remarks
- Doxycycline extended release (ER) may be an alternative to twice daily dosing ofdoxycycline, but the high cost may prohibit its use.
- If using an alternative treatment for gonococcal infection (cefixime 800 mg plusazithromycin 2 g), maintain the 2 g dosage of azithromycin to cover chlamydialinfection.
- Note that doxycycline, tetracycline and ofloxacin are contraindicated in pregnantand breastfeeding women (see separate recommendations for pregnant andbreastfeeding women).