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Chlamydia pregnancy — USMLE Step 3 MCQ

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HardOB/GYN (Prenatal / Contraception / Screening)Chlamydia pregnancyUSMLE Step 3

A 24-year-old woman at 18 weeks of gestation has a positive nucleic-acid test for Chlamydia trachomatis and no pelvic pain. Her partner has not yet been evaluated. Which regimen and follow-up plan is preferred?

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Correct answer: A — Give azithromycin 1 g orally once, perform a NAAT test of cure in about 4 weeks, and ensure partner treatment

The best answer is “Give azithromycin 1 g orally once, perform a NAAT test of cure in about 4 weeks, and ensure partner treatment”. Azithromycin is the recommended regimen during pregnancy. Test of cure occurs about 4 weeks later, retesting occurs at 3 months, and partners require treatment to prevent reinfection; amoxicillin is an alternative rather than the preferred regimen. Chlamydia during pregnancy is treated with azithromycin 1 g orally once, followed by NAAT test of cure at about 4 weeks, repeat testing at 3 months, and partner treatment.

Reference: CDC STI Guidelines: Chlamydial Infections: https://www.cdc.gov/std/treatment-guidelines/chlamydia.htm