title: A recommendation for timing of repeat Chlamydia trachomatis test following infection and treatment in pregnant and nonpregnant women.
abstract: The objective of this study was to describe the time required to obtain a negative chlamydia test in pregnant and nonpregnant women following treatment to inform test-of-cure collection and recommend an abstinence period to avoid reinfection. Seventy-two women with Chlamydia trachomatis infection, 36 pregnant and 36 nonpregnant, were enrolled in a prospective cohort study. Women were excluded less than 18 years of age, if they had been treated for chlamydia, reported an allergy to macrolide antibiotics, or if they had Myasthenia Gravis. Women were treated for chlamydia with single-dose therapy and submitted weekly vaginal chlamydia nucleic acid amplification tests (NAATs). Once NAAT were negative, the participants completed the study. Forty-seven women completed the study per protocol. The primary outcome was to determine the time to a negative chlamydia NAAT following treatment, with secondary outcomes of determining the appropriate time to collect a test-of-cure following chlamydia treatment and to recommend an appropriate abstinence period following treatment to avoid reinfection. Results showed that the time to a negative chlamydia NAAT was significantly different between groups (log-rank p = 0.0013). The median number of days to obtain a negative chlamydia NAAT was 8 days (IQR 7-14) in pregnant and 7 days (IQR 6-10) in nonpregnant women (WRST p = 0.04). All participants had a negative chlamydia NAAT by day 29 post-treatment. Following single-dose treatment for chlamydia, both pregnant and nonpregnant women should test negative with NAAT by 30 days post-treatment. Clinicians should collect a test-of-cure in pregnant women no earlier than 1 month. To avoid reinfection, women should avoid condomless intercourse for at least 1 month.
authors.affiliation: 1 Department of Obstetrics and Gynecology, Medical University of South Carolina, Charleston, SC, USA.
authors.forename: Gweneth B
authors.initials: GB
authors.lastname: Lazenby
authors.affiliation: 2 Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC, USA.
authors.forename: Jeffrey E
authors.initials: JE
authors.lastname: Korte
authors.affiliation: 1 Department of Obstetrics and Gynecology, Medical University of South Carolina, Charleston, SC, USA.
authors.forename: Sarah
authors.initials: S
authors.lastname: Tillman
authors.affiliation: 1 Department of Obstetrics and Gynecology, Medical University of South Carolina, Charleston, SC, USA.
authors.forename: Florence K
authors.initials: FK
authors.lastname: Brown
authors.affiliation: 1 Department of Obstetrics and Gynecology, Medical University of South Carolina, Charleston, SC, USA.
authors.forename: David E
authors.initials: DE
authors.lastname: Soper
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D002690:Chlamydia Infections / Q000188:drug therapy* / Q000382:microbiology; D002692:Chlamydia trachomatis / Q000187:drug effects* / Q000235:genetics / Q000302:isolation & purification*; D005260:Female; D006801:Humans; D008403:Mass Screening / Q000379:methods*; D011247:Pregnancy; D012329:RNA, Bacterial / Q000187:drug effects* / Q000235:genetics; D013997:Time Factors; D016896:Treatment Outcome; D014621:Vagina / Q000382:microbiology; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D012329:RNA, Bacterial
keywords: Chlamydia trachomatis; pregnant women; test-of-cure