Treatment practices for chlamydial infection in New Zealand

To identify prescribing and treatment practices for chlamydial infection in New Zealand.

Postal survey to doctors and nurses at all sexual health, family planning, student and youth health centres, and randomly selected general practitioners.

There was considerable variation in treatment regimes used for chlamydial infection with few respondents treating in accordance with international guidelines regarding dose, frequency, and duration of treatment. Doxycycline (88.4%) was most commonly used to treat uncomplicated chlamydial infection in non-pregnant patients. Most respondents (70.2%) stipulated doxycycline for longer durations than the seven day regimen international guidelines recommend, with doxycycline 100 mg twice a day for ten days most frequently specified. Among the 259 respondents who would treat pregnant women with erythromycin, 51 different treatment regimens were specified, and 51.7% recorded regimens less than that recommended by international guidelines. When treating a patient presumptively, the majority of respondents tested for chlamydial infection. In contrast to other respondents, sexual health clinic staff rarely provide patients with a prescription for a patient's partner without seeing the partner.

Standardised treatment guidelines are required for patients diagnosed with chlamydial infection. Guidelines should include recommendations for the treatment of partners, and encourage the laboratory confirmation of diagnosis.