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One of the first things to make sure of when you are getting antibiotics for chlamydia is that you are getting the right drug. Two commonly prescribed antibiotics are effective against the disease. These are Zithromax (azithromycin) and Oracea (doxycycline, which also is sold under the brand names Atridox, Monodox, Doryx, Vibra-Tabs, Periostat, Morgidox, Ocudox, and Alodox). Some doctors prescribe antibiotics that just won't work, such as Proloprim or Cipro (trimethoprim-sulfamethoxazole or Ciprofloxacin). There are other antibiotics that also can be used to treat chlamydia, but these are added on to treatment in especially complicated cases.

The most recent research finds that a single tablet of Zithromax is as effective against chlamydia as a full seven days of Oracea (doxycycline). There are numerous advantages to a single-dose treatment. You don't have to take pills twice a day, the way you do with doxocycline. Your doctor can be absolutely sure you got your treatment, because he or she will give it to you in the doctor's office. You don't have to worry about somebody at the drugstore noticing that you are getting treated for an STD and blabbing your confidential information to others, because the pharmacy will not be involved.

However, if your doctor has not sent a urine sample to the lab and come back with a confirmation that chlamydia is what you have, Zithromax can be a mistake. Zithromax doesn't treat other infections that can cause similar infections. 

Doxocycline can treat not just chlamydia but also other infections that cause the same symptoms.

These drugs are appropriate for "uncomplicated" cases of chlamydia. If there is any suspicion that the infection has spread further up the urogenital tract, to the cervix and uterus in women or to the prostate or bladder in men, then there are different treatments. 

Untreated pelvic inflammatory disease can cause infertility, chronic pain, or even life-threatening sepsis. It is absolutely essential that you get the full course of antibiotic treatment if you have an infection that has caused pelvic inflammatory disease. Doctors have low confidence in the ability of teenagers to take all their prescribed medications, and for that reason, they may insist that very young people with this more severe form of chlamydia take their treatment as in-patients in the hospital. In the hospital, antibiotic drugs are delivered by IV, and they are usually given for 14 days. The prescribed treatment is no longer Zithromax, but cefoxitin or cefotetan along with a 14-day course of doxycycline or, alternatively, clindamycin plus gentamicin or ampicillin-sulbactam plus doxycycline. It isn't necessary to stay in be the whole time you are in the hospital, but you will have to get around moving your IV pole around with you when you go to the bathroom, and get wrapping around your IV site when you take a shower. 

The positive outcome of this treatment is that IV antibiotics usually "knock out" not just chlamydia but also gonorrhea and any other anaerobic bacterial infections that may be present.

In severe cases, follow-up is essential. You will be asked to see your doctor a day or two after you get out of the hospital, just to make sure some especially virulent infection hasn't flared up as you were taken off the IV antibiotics. Then you will need to get tested again in about a month. At this point, it's not unusual to get a false positive; that is, the test comes back that you still have the infection when actually you don't. That's because your body will still be eliminating dead bacteria up to a month after IV treatment, and many of the tests can mistake dead bacteria for live bacteria that can cause disease.

What's the message to take away from these facts? If you catch chlamydia in time, a single treatment with Zithromax might be all you need to get rid of the infection, and you might be infection-free in just a week. Don't decide for yourself that you are over the infection, however. Let your doctor run a second test about a week after you take your antibiotics to make sure the chlamydia is gone for good.

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