Chlamydial cervicitis: complications and new treatment options

Chlamydial cervicitis has the potential for serious gynecologic complications, including pelvic inflammatory disease, infertility and ectopic pregnancy. In the pregnant patient, this infection is associated with premature rupture of membranes and increased fetal morbidity and mortality. In addition, infants infected by passage through an infected cervix are at risk for respiratory complications and conjunctivitis. Chlamydial cervicitis may, however, be asymptomatic, and no single risk factor has been identified that reliably predicts infection. Current recommendations are to screen all pregnant women and patients in high-risk populations, such as those attending clinics for sexually transmitted diseases. Screening tests for chlamydial cervicitis are limited by expense and technical difficulties in obtaining and handling specimens. Chlamydial cervicitis can be treated effectively with several antibiotics, including doxycycline, ofloxacin and erythromycin. Newer antibiotics such as azithromycin offer the potential of effective single-dose treatment.