Antibiotics are among the greatest advances in medicine over the last century, but how do they relate to chlamydia treatment. Yet not every antibiotic is suitable for treating every type of bacterial infection – and it’s now a well-known fact that antibiotics should not be prescribed for non-bacterial infections. Despite this, many doctors resort to prescribing antibiotics inappropriately – usually before confirming the infection is bacterial in nature and identifying which antibiotic will actually be most effective on a per-case basis. 

This antibiotic overuse has contributed to the growth of antibiotic-resistant strains of bacteria. This is becoming of significant concern in terms of chlamydia antibiotic treatment and the rising resistance of the infection to macrolide antibiotics.

What is Chlamydia?

Chlamydia is a very common sexually transmitted infection (STI) that is caused by the bacteria strain Chlamydia trachomatis. It is predominantly transmitted through semen or vaginal discharge (in which the bacteria thrive) via unprotected vaginal sex, anal sex, or oral sex when no condom or other barrier method is used. 

Chlamydia is the most common STI in Australia today. It is most prevalent among people aged between 15 and 25 years but can affect people at any age. In 2020, there were 329.4 chlamydia cases per 100,000 population in Australia.

Chlamydia affects significantly more women than men, though both sexes are vulnerable to contracting and transmitting the infection. When one partner has chlamydia, there is between 30-50% chance the other will catch it every time they have unprotected sexual contact.

  • It’s important to understand that penetration does not need to occur for the bacteria to be passed on; exterior genital contact with a carrier is enough to contract chlamydia. 
  • Newborn babies can also acquire chlamydia from the mother’s birth canal. 
  • Chlamydia can NOT be spread via toilet seats, swimming pools, or non-sexual contact.

Risk Factors include:

  • Not consistently using condoms (or other barrier methods) with new sexual partners
  • Having a non-monogamous sexual partner
  • A history of chlamydia or other STIs

Chlamydia can be a “silent infection” – most people who have the infection experience no symptoms. The infection can survive in the genitals, rectum, nose, or throat for more than two years. 

While 75% of women and 50% of men with chlamydia infection display no early symptoms, untreated, it can trigger significant health issues and complications later, including inflammation, skin rashes, and even arthritis. Men may not display symptoms for months; women not for years. 

When they do occur, symptoms of chlamydia can be similar to those of other STIs. In men, the bacteria usually infect the urethra and the testicles. In women, it mostly infects the cervix. 

Symptoms include:

Men & Women:

  • Burning sensation with urination
  • Anal pain, discharge, or bleeding (if transmitted via anal sex)
  • Sore throat, cough, or fever (if transmitted via oral sex)
  • Eye infection with chlamydia is possible (but not common) if there is contact between the mouth or genitals and eyes.


  • Testicular pain 
  • Lower abdominal pain
  • Clear/milky/yellow/green discharge from the penis 


  • Pain during sexual intercourse (dyspareunia) 
  • Inflammation of the cervix (cervicitis) 
  • Abnormal vaginal discharge 
  • Vaginal bleeding between periods 
  • Lower abdominal/pelvic pain

Women, in particular, may not experience any symptoms until several weeks after infection with chlamydia occurs. 

Pregnant women have higher ectopic pregnancy, miscarriage and premature birth risk if they have chlamydia, and untreated infection can often cause infertility. Men may also experience fertility issues.

Women are also vulnerable to developing Pelvic Inflammatory Disease (PID) if chlamydia infection spreads to the fallopian tubes. Symptoms may include fever, nausea, severe pelvic pain, and abnormal vaginal bleeding. This is a medical emergency.

Chlamydia Treatments

Symptoms of chlamydia can mimic those of various other STIs and non-infectious conditions. It’s important to be screened regularly for chlamydia (and other STIs) if you are sexually active and not in a long-term, mutually monogamous relationship. This will enable appropriate, timely treatment, prevent the spread and help you avoid developing complications from the infection.

Chlamydia is easily diagnosed via a urine sample or a swab sample from the vagina, cervix, penis, throat, or anus. 

Chlamydia treatment for a confirmed infection involves a single (usually) course of antibiotics such as azithromycin or doxycycline. Your partner will also require treatment. You must avoid sexual contact of all kinds during and for one full week after finishing your treatment course. Re-testing will be required in three months.

Reinfection is possible. Reduce your risks:

  • Use a condom every time you have vaginal, oral, or anal sex
  • Don’t have sex while you have or are being treated for chlamydia
  • Don’t have sex with someone who has chlamydia (even with a condom) until they have completed treatment
  • Get screened regularly for STIs (as often as every three months if you have multiple or frequently changing partners)

Issues with High Antibiotic Prescription Rate Without Diagnosis for Chlamydia

Australian STI Management Guidelines for treating chlamydia recommend that doctors commence antibiotic chlamydia treatment on the presumption that a case is positive before the urine or swab analysis has returned to confirm the diagnosis. This has inadvertently led to overtreatment with antibiotics and the rise in resistance of Chlamydia trachomatis to the drugs used to eliminate it.

A review of more than 300 cases from a walk-in sexual health clinic revealed that 75% of those patients prescribed an antibiotic presumptively for chlamydia treatment returned a negative screening result. Some had a different STI (for which a different antibiotic drug may have been more suitable), while 50% had no STI at all. In these cases, antibiotic treatment was entirely unsuitable. 

In Australia in 2020, there were just 4.8 notifications of positive chlamydia cases per 100 tests. 

Because chlamydia is not a life-threatening condition, a balance should be struck between the consequence of slightly delayed treatment and the overuse of antibiotics. A short delay in commencing chlamydia treatment until diagnostic pathology results are available should be considered in all cases where the patient is likely to be available for follow up with the doctor or sexual health clinic in the next few days. In cases where patients are unlikely to follow up or comply, presumptive antibiotic treatment has an important role to play. 

What to Do if You Suspect You Have an STI

If you or your partner suspect that one of you has, or has potentially been exposed to, chlamydia or another STI, get tested promptly. 

In Australia, chlamydia is a notifiable infection and government health authorities track infection rates. If you have a positive result, you will need to contact your sexual partners from the last 6 months so that they too may be tested and commence chlamydia treatment if necessary.

If you are under the age of 30 years and are sexually active, Australian health recommendations suggest regular screening for chlamydia and other STIs; this can often be performed while having other routine checkups. 

Book a Consultation at Gynaecology Centres Australia 

Gynaecology Centres Australia operates from five convenient clinic locations in NSW and the ACT. We provide confidential and judgement-free women’s contraceptive health / gynaecology services, including STI screening with procedures and we provide appropriate treatments. 

You do not require a referral from your GP to visit our clinics.


Please call 02 9585 9599 or complete our online booking form.