Chlamydia trachomatis in subfertile women undergoing uterine instrumentation. The clinician's role.
Most women attending a fertility clinic will undergo uterine instrumentation either diagnostically and/or therapeutically. This places them at potential risk of chlamydial pelvic inflammatory disease. Clinicians remain unclear about the roles of screening, serology and prophylactic antibiotics. A review of the evidence suggests that women <25 years and those older with risk factors, men with risk factors and gamete donors should have their lower genital tract screened for Chlamydia trachomatis by a sensitive test. More information is required before screening men by age can be recommended. Serology in its present form cannot be advocated as a screening tool. Those women with a past history of chlamydial morbidity or a diagnosis of tubal pathology should, in addition to screening, be covered with prophylactic antibiotics when undergoing uterine instrumentation. The partner should be screened for sexually transmitted infections. Non-selective use of prophylactic antibiotics serves only to increase the problem of antibiotic resistance and maintain the bacterial load of chlamydia in the community.
Macmillan
Susan
S
Department of Obstetrics and Gynaecology, Aberdeen Maternity Hospital, Foresterhill, Aberdeen, UK. ogy167@abdn.ac.uk
D000328:Adult; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D000907:Antibodies, Bacterial / Q000097:blood; D002690:Chlamydia Infections / Q000150:complications* / Q000175:diagnosis*; D002692:Chlamydia trachomatis / Q000276:immunology; D005260:Female; D006801:Humans; D007247:Infertility, Female / Q000150:complications / Q000175:diagnosis; D008297:Male; D000292:Pelvic Inflammatory Disease / Q000517:prevention & control; D012747:Sexual Partners
D000900:Anti-Bacterial Agents; D000907:Antibodies, Bacterial