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Chlamydia trachomatis among Patients Infected with and Treated for Neisseria gonorrhoeae in Sexually Transmitted Disease Clinics in the United States

Sheryl B. Lyss, MD; Mary L. Kamb, MD, MPH; Thomas A. Peterman, MD, MSc; John S. Moran, MD, MPH; Daniel R. Newman, MA; Gail Bolan, MD; John M. Douglas Jr., MD; Michael Iatesta, MA; C Kevin Malotte, DrPH; Jonathan M. Zenilman, MD; Josephine Ehret, BS; Charlotte Gaydos, MS, MPH, DrPH; Wilbert J. Newhall, PhD, for the Project RESPECT Study Group*
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From Centers for Disease Control and Prevention, Atlanta, Georgia; San Francisco Health Department, San Francisco, California; Denver Public Health, Denver, Colorado; New Jersey Department of Health, Newark, New Jersey; California State University, Long Beach, California; and Baltimore City Health Department and Johns Hopkins University, Baltimore, Maryland.


Ann Intern Med. 2003;139(3):178-185. doi:10.7326/0003-4819-139-3-200308050-00007
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Because of the changing epidemiology of STDs in the United States, we anticipated that the prevalence of chlamydia among patients treated for gonorrhea might have become low enough to reconsider universal co-treatment. These data suggest otherwise. Patients with laboratory-confirmed gonococcal infection were frequently co-infected with C. trachomatis (20% in men and 42% in women). More important, chlamydia was very common among patients with treatment indications for gonorrhea who would not, in the absence of co-treatment, have been treated for chlamydia (19% in men and 35% in women), particularly those younger than 25 years of age (25% in men and 47% in women). In fact, a clinical or epidemiologic indication for gonorrhea therapy was a surprisingly strong predictor of chlamydial infection, as strong a predictor of chlamydia for men and an even stronger predictor for women than common and more direct indicators (nongonococcal urethritis, mucopurulent cervicitis, PID, or chlamydia-infected sex partner).

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Summary for Patients

Chlamydia Infection among Patients Receiving Treatment for Gonorrhea in Sexually Transmitted Disease Clinics in the United States

Sexually transmitted diseases (STDs) are infections spread from one person to another during sexual relations. Chlamydia trachomatis (chlamydia) and Neisseria gonorrhoeae (gonorrhea) are bacteria that are common causes of STDs in the United States. Both infections can cause symptoms such as discharge from the vagina or penis, pain with urination, or abdominal pain. However, many people with chlamydia or gonorrhea have no symptoms. Treatment with antibiotic drugs is important to get rid of symptoms, avoid spreading the infection to other people, and prevent complications of the infections. In women, chlamydia and gonorrhea infection can cause difficulties in becoming pregnant (infertility). Infections in pregnant women can lead to premature or low-birthweight infants and serious infections in newborns.

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