Is there a need for rescreening of patients treated for genital chlamydial infections?

Abstract

Summary:The present communication reviews reasons to perform rescreening of chlamydia-infected persons. It brings up dif® culties to differentiate between relapse and reinfection. Studies on follow-up of chlamydia-positive cases after therapy are reviewed. It also highlights reasons for therapeutic failure, like compliance, pharmacological factors, including poor bioavailability, wrong dose regimens, lack of adherence to drug intake, neglect of partner noti® cation and concomitant therapy in consorts, possible development of resistance to drugs generally prescribed, false negative or false positive diagnostic tests and reinfection from extra-genital not`cured' sites. The review points to the need to establish programmes for routine rescreening of chlamydia-infected persons.

Uncommon occurrence of fluoroquinolone resistance-associated alterations in GyrA and ParC in clinical strains of Chlamydia trachomatis

“…In the patient with persistent NGU, the treatment failure may have been due to other factors, such as incomplete compliance with the treatment, poor bioavailability, unfavorable pharmacokinetics, or re-infection. 20 Clinical studies with ofloxacin and levofloxacin have shown high eradication rates of C. trachomatis. [21][22][23] In previous studies in which fluoroquinolone-susceptible strains of C. trachomatis were exposed to sub-MICs of fluoroquinolones to select fluoroquinolone-resistant mutants in vitro, resistance did not occur during several serial passages equivalent to a typical treatment period.…”

Chlamydia in Gynecologic Practice

“…The use of NAATs is endorsed. Most authorities do not recommend a routine test of cure if the patient has been given and complied with appropriate treatment; however, some do [51]. The importance of partner notification and screening is highlighted.…”

Sexually transmitted diseases putative drug target database: A comprehensive database of putative drug targets of pathogens identified by comparative genomics

“…Reason for such non-compliance is yet to be discovered. [23] H. ducreyi showed more resistance than Escherichia coli to antimicrobial peptides. It is also recognized to possess β-lactamase activity making it resistant to the antibiotic ampicillin.…”