A sexually active 24-year-old man presents with urethral discharge. Gram stain shows no diplococci. Nucleic acid amplification test (NAAT) from first-void urine is positive for Chlamydia trachomatis but negative for Neisseria gonorrhoeae. What is the recommended treatment per current WHO/NACO STI guidelines?

• A Ciprofloxacin 500 mg single dose
• B Penicillin G benzathine 2.4 MU IM single dose
• C Metronidazole 2 g single dose
• D Doxycycline 100 mg twice daily for 7 days or azithromycin 1 g single dose ✓

Explanation

WHO STI treatment guidelines recommend doxycycline 100 mg orally twice daily for 7 days as the preferred regimen for uncomplicated urogenital chlamydia (NAATs confirmed), with azithromycin 1 g orally single dose as an alternative. Doxycycline is now preferred over azithromycin based on recent trial data showing higher efficacy for rectal chlamydia. Ciprofloxacin covers gonorrhoea in some settings but has no role in chlamydial infection. Benzathine penicillin is for syphilis. Metronidazole targets anaerobes and protozoa.

Reference: Ananthanarayan & Paniker's Textbook of Microbiology, 11th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.