Chlamydial Infection Flashcards
What is chlamydia?
- Caused by bacterium ‘Chlamydia trachomatis’
- Bacteria found in semen of men + vaginal fluids of women
- Easily passed on through UPSI
What are the symptoms of chlamydia in women?
- Pain when urinating
- Unusual vaginal discharge
- Pain in the tummy/pelvis
- Pain during sex
- Bleeding after sex
- Bleeding between periods
What are the symptoms of chlamydia in men?
- Pain when urinating
- White, cloudy or watery discharge from the tip of the penis
- Burning or itching in the urethra (tube that carries urine out of the body)
- Pain in the testicles
Why are chlamydia screening programmes important?
Offers free testing, treatment and partner management + prevention to sexually active young people under the age of 25.
What are the goals of the chlamydia screening programme?
- Prevent + control chlamydia through early detection + treatment of asymptomatic infection
- Reduce onward transmission to sexual partners
- Prevent the consequences of untreated infection
What consequences can long-term infection of chlamydia cause?
Lead to serious long-term consequences.
Women = lead to Pelvic inflammatory disease, ectopic pregnancy + tubal infertility.
Men = can lead to epididymitis (inflammation of tube that carries and stores sperm) + epididymo-orchitis
Women + Men = lead to Reiter’s Syndrome (form of arthritis)
Why is chlamydia difficult to diagnose without the screening programme?
Many do not get symptoms, but easy to treat.
What are the 6 main aims of providing chlamydia testing in community pharmacies?
- Maximise capacity of CP + GP to deliver chlamydia testing, treatment + partner management = cost effective
- Increase access to the NCSP by providing additional locations to access testing
- Increase access to treatment of asymptomatic individuals
- Increase access for young people to sexual health advice
- Increase patients knowledge of the risks associated with STIs
- Strengthen the network of contraceptive + sexual health services to help provide easy + swift access to advice
What patients are suitable for chlamydia treatment in a pharmacy?
- Provide chlamydia testing kits to people <25 e.g. if they are buying condoms, contraception or EHC
- Advice on how to use the kit, how to return it for testing + what will happen following completion of the test
(Under 16 if Fraser competent can be provided)
What are the 5 Fraser guidelines?
- Young person (YP) understands HCP advice
- Cannot persuade YP to inform his/her parents that they’re seeking contraceptive advice
- YP is v likely to begin/continue having sex with or without contraceptive treatment
- Unless receives the treatment, the YP’s physical/mental health is likely to suffer
- YP’s best interests require the HCP to give contraceptive advice or treatment without parental consent
What do you do if a patient falls in the exclusion criteria of the PGD for the treatment with azithromycin for chlamydia?
- Explain reasons for exclusions with client + document
- Consider whether a doxycycline PGD could be used
- If not refer to GUM (sexual health clinic) or GP ASAP
- Male client with scrotal pain: consider immediate referral to A&E to exclude torsion of the testes
- Female client with pelvic pain: consider immediate referral to GUM or Gynaecology on-call service
- Presence of genital tract symptoms: consider immediate referral to GUM
- Concomitant conjunctivitis and/or joint pain: consider immediate referral to GUM/A&E
- Record in records
What is the medicine, dose and regimen for the treatment of chlamydia?
Azithromycin
- 1 gram as a single dose
- Taken as 4 x 250mg tablets
What verbal info should be given to patient before taking azithromycin?
- Tablets should be swallowed whole with a cup of water
- If food has been eaten within the last 2hours, delay administration.
- Where possible avoid indigestion remedies.
- If taking antacids, take azithromycin 1 hr before/2 hrs after.
- Abstain completely from sexual contact for 7 days after your treatment and partners treatment.
What advice should be given is a patient is treated for chlamydia and is using oral contraception?
- Take as usual
- If given antibiotics in 1st week of pill packet + had sex recently = may require EHC
- If client is at end of packet for the combined pill whilst taking or within 7 days after taking, advise to start new packet straight away.
- Do NOT have the usual 7 day break or take placebo tablets.
- Bleeding is normal
What are the side effects of azithromycin?
- Anorexia
- Dyspepsia (indigestion)
- Constipation
- Dizziness
- Headache
- Drowsiness
- Risk of thrush
