RECOMMENDATIONS for treatment of infections caused by Chlamydia trachomatis were last established in 1982.1 Since that time, studies have provided new information about the epidemiology and the clinical spectrum of the diseases associated with C trachomatis infections. In addition, new antimicrobial agents have become available and old agents have been studied more extensively in treatment trials. These recent developments prompt the need for an updated review of the treatment of these widespread infections.
Chlamydial infections are now recognized as the most common bacterial sexually transmitted diseases in the United States. An estimated 3 million people have infections caused by C trachomatis each year.2Chlamydia trachomatis is the leading cause of nongonococcal urethritis (roughly 50%) and of epididymitis in men younger than 35 years of age. In women, where the majority of infections are asymptomatic, C trachomatis infection causes mucopurulent cervicitis, urethral syndrome, and pelvic inflammatory disease (PID).