Clinical Practice Alert: Chlamydia and Gonorrhea Screening and Treatment

June 20, 2019

Rates of sexually-transmitted diseases (STDs) such as chlamydia trachomatis (CT) and gonorrhea (GC) have reached an all-time high. In the U.S., California leads the nation in reported cases of these STDs. Because persons with CT and GC are often asymptomatic, screening is essential for the early detection and treatment that can prevent reproductive complications including pelvic inflammatory disease (PID), tubal infertility, ectopic pregnancy, and chronic pelvic pain in females and epididymitis in males.

This webinar covers current clinical guidelines for routine and targeted screening, treatment, follow-up, and prevention of CT and GC.

Learning objectives:

  1. Understand current guidelines for screening for CT and GC among sexually active women and men
  2. List the indications for anorectal and oropharyngeal CT/GC screening
  3. Explain when test-of-cure is indicated
  4. Identify the proper ICD-10 codes for lab requests and billing information

Presenters:

Resources:

Extragenital Screening

Don’t forget to swab! Among men who have sex with men, 84% of gonorrhea and chlamydia infections would be missed with urine-only screening1. Make sure your clients are screened for gonorrhea and chlamydia of the throat and rectum.

3 cotton swabs
What:Extragenital Screening for Gonorrhea and Chlamydia
Where:Rectum and throat
Who:Men who have sex with men (MSM), transgender women, people living with HIV, and people on PrEP who report having receptive anal and/or oral sex
When:At least annually, or every 3 to 6 months as needed based on exposure
Why:  When urine-only screening is performed, up to 90% of rectal gonorrhea and 77% of rectal chlamydia infections remain untreated1. HIV-negative men diagnosed with rectal infections are excellent candidates for PrEP, because they have a high risk of HIV infection
How: Swab specimen (self or clinician-collected swab)

The California Prevention Training Center supports clinics and providers in implementing rectal and pharyngeal STI screening.

For more information, contact us.

  1. Marcus JL, Bernstein KT, Kohn RP, Liska S, Philip SS. Infections missed by urethral-only screening for chlamydia or gonorrhea detection among men who have sex with men. Sexually transmitted diseases. 2011 Oct 1;38(10):922-4.

Extragenital Screening Resources

Extragenital (rectum and throat) gonorrhea and chlamydia screening resources for providers, clinics, and patients. 

CAPTC logo

California Guidelines for Suspected Gonorrhea Treatment Failure

Discusses treatment of uncomplicated gonorrhea and what clinicians should do in cases of potential treatment failures.

California Department of Public Health Logo

CDC Gonorrhea Fact Sheet

Basic and detailed patient-facing fact sheets about gonorrhea prevention, screening, and treatment.

CDC logo