Couple being close to each other in bed after treatment with amoxicillin for chlamydia

Amoxicillin for Chlamydia: Key Points to Know

Written on July 18, 2023 by Sendra Yang, PharmD, MBA. To give you technically accurate, evidence-based information, content published on the Everlywell blog is reviewed by credentialed professionals with expertise in medical and bioscience fields.

Table of contents

Before the 1940s, infections were primarily treated with surgical drainage, antiseptics, silver compounds, or other types of tinctures.[1] Since their introduction, antibiotics have been used to treat many infectious diseases and have proven effective against serious bacterial infections.[1] Sexually transmitted diseases (STDs) caused by specific bacteria, including chlamydia, can be treated with antibiotics.[2,3] Amoxicillin is an antibiotic treatment option for those infected with chlamydia.[4] Read on to learn more about chlamydia and treatment options, specifically amoxicillin for chlamydia.

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Prevalence of Chlamydia

Chlamydia is the most frequently reported bacterial STD in the US.[3] In 2018, the CDC estimated approximately four million chlamydia infections.[3] About 1 in 20 sexually active women between the ages of 14 to 24 years old have chlamydia. In 2021, there were over 2.5 million new cases of chlamydia, gonorrhea, and syphilis reported.[5]

Causes of Chlamydia

Chlamydia is an STD caused by infection of the bacteria Chlamydia trachomatis.[3] It spreads through vaginal, anal, or oral sex with a person infected with the bacteria. Pregnant women can also transmit chlamydia to their babies during childbirth, leading to conjunctivitis or pneumonia in some babies.

Symptoms of Chlamydia

Most people with chlamydia have no symptoms or abnormalities in their physical exams.[3] In women, C. trachomatis can infect the cervix, urethra, and upper reproductive tract. Symptoms can include mucopurulent endocervical discharge, easily induced endocervical bleeding, pyuria, dysuria, and urinary frequency. Chlamydia infection can also lead to pelvic inflammatory disease, infertility, and ectopic pregnancy in women.[3] Men typically present with urethritis symptoms, a mucoid or watery urethral discharge, and dysuria. Men can also experience epididymitis, testicular pain, tenderness, and swelling. Additionally, C. trachomatis can infect the rectum, throat, and eyes in both men and women.

Treatment for Chlamydia

Chlamydia can be cured, and antibiotics are the mainstay treatment for the infection.[3,4] The CDC recommends doxycycline for seven days as the initial treatment for chlamydial infection among adolescents and adults.[4] Alternative regimens are azithromycin as a single dose or levofloxacin for seven days. If you are treated with a single-dose antibiotic, you need to abstain from having sex for seven days. If treated with a seven-day regimen, you should not have sex until you complete the course and no longer have symptoms.

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Chlamydia Treatment in Pregnancy

If you are pregnant, the preferred and recommended antibiotic therapy is a single dose of azithromycin. The alternative regimen is amoxicillin for seven days. Doxycycline is contraindicated during the second and third trimesters of pregnancy due to the risk of tooth discoloration in the unborn baby. Levofloxacin is also contraindicated during pregnancy.[6] However, studies on humans show levofloxacin presents a low risk to the fetus; it has potential toxicity during breastfeeding and shows cartilage damage to neonates in animal studies.[4]

The alternative antibiotic regimen the CDC recommends during pregnancy is 500 mg of amoxicillin, taken orally three times daily for seven days.[4] Your healthcare provider may recommend amoxicillin for chlamydia treatment if you are allergic to or cannot take azithromycin.

What Is Amoxicillin?

Amoxicillin is a commonly used antibiotic in a class known as beta-lactams.[7] The beta-lactam class of antimicrobials works by binding to a protein in the bacterial cell wall that activates its breakdown. The bacterial cell is destroyed by breaking down the cell wall, killing the bacteria. Amoxicillin is effective against a wide range of microbes and covers most Streptococcus, Enterococcus, and Salmonella species. It also covers Listeria monocytogenes, Haemophilus influenza, and Chlamydia trachomatis.[4,7]

Side Effects of Amoxicillin

Amoxicillin is, overall, a well-tolerated antibiotic.[7] Common side effects of amoxicillin are gastrointestinal symptoms such as nausea, vomiting, and diarrhea. Other adverse effects of amoxicillin include insomnia, anxiety, confusion, hemolytic anemia, and hypersensitivity vasculitis. Liver and kidney toxicity, hypersensitivity reactions, and superinfections (severe secondary infections) may also occur.

Tips for Using Antibiotics for Chlamydia Treatment

If you have been prescribed antibiotics for chlamydial infection, here are some tips to follow (but be sure to consult with your healthcare provider for their specific recommendations) [7,8]:

  • For a seven-day treatment regimen, you should not have sex until you complete the course and no longer have symptoms
  • Do not share your chlamydia medication with anyone
  • If your symptoms continue for more than a few days after receiving treatment, you should reach back out to your healthcare provider
  • Sex partners who have not been appropriately tested are at high risk for repeat infection

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Everlywell offers STI treatment online with a licensed healthcare provider via telehealth. If you think you may have been exposed to a sexually transmitted infection or disease, you can connect with a clinician in less than two hours. You can discuss your sexual health questions and concerns with the clinician during your appointment, and they will provide personalized recommendations on the next steps based on your symptoms and exposure history.

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Doxycycline for STDs: What It Is and How It Works

Azithromycin vs. Doxycycline: What's the Difference?

Can Genital Herpes Be Cured?

References

  1. Zinner SH. Antibiotic use: present and future. New Microbiol. 2007;30(3):321-5. PMID: 17802919
  2. CDC - STD Diseases & Related Conditions. Centers for Disease Control and Prevention. https://www.cdc.gov/std/general/. Last reviewed July 7, 2023. Accessed July 14, 2023.
  3. Detailed STD Facts - Chlamydia. Centers for Disease Control and Prevention. https://www.cdc.gov/std/chlamydia/stdfact-chlamydia-detailed.htm. Last reviewed April 11, 2023. Accessed July 14, 2023.
  4. Chlamydial infections - STI treatment guidelines. Centers for Disease Control and Prevention. https://www.cdc.gov/std/treatment-guidelines/chlamydia.htm. Last reviewed July 22, 2021. Accessed July 14, 2023.
  5. Sexually transmitted disease surveillance, 2021. Centers for Disease Control and Prevention. https://www.cdc.gov/std/statistics/2021/default.htm. Last reviewed April 11, 2023. Accessed July 14, 2023.
  6. Podder V, Sadiq NM. Levofloxacin. [Updated 2022 Sep 23]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023. https://www.ncbi.nlm.nih.gov/books/NBK545180/.
  7. Akhavan BJ, Khanna NR, Vijhani P. Amoxicillin. [Updated 2022 Aug 8]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023. https://www.ncbi.nlm.nih.gov/books/NBK482250/.
  8. CDC – Chlamydia treatment. Centers for Disease Control and Prevention. https://www.cdc.gov/std/chlamydia/treatment.htm. July 22, 2021. Accessed July 14, 2023.
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