Gonorrhea & 
Chlamydia Toolkit for 
Healthcare Providers

In the U.S., chlamydia and gonorrhea are the most reported sexually transmitted infections (STIs), and rates of antibiotic-resistant gonorrhea are increasing.

• 10,806 Chlamydia Total Cases
  • 472.5 Chlamydia Rate (per 100,000 population)
• 3,061 Gonorrhea Total Cases
  • 133.8 Gonorrhea Rate (per 100,000 population)

Find the latest Cook County STI surveillance reports.

Who is most at risk

Anyone can get an STI. However, most reported chlamydia and gonorrhea cases are under 24 years of age.

In 2023:

• The chlamydia rate was:
  • About 11 times higher among non-Hispanic Black/African American persons than non-Hispanic Whites.
  • 4 times higher among Hispanic/Latino persons than non-Hispanic Whites
• The gonorrhea rate was:
  • 18 times higher among non-Hispanic Black/African Americans than in non-Hispanic Whites.
  • 5 times higher among Hispanic/Latino persons than in non-Hispanic Whites.

We Need Your Help

Health care providers can play a critically important role in helping to reduce gonorrhea and chlamydia in suburban Cook County by taking the following actions:

Report. It’s The Law

Report gonorrhea and chlamydia to the health department as soon as possible but within 7 days so we can help you, your patients and their partners.

Ways to report

• Sign into the Illinois Disease Surveillance System (IDSS) online web portal.
  • Providers who have logged into I-NEDSS between December 2022 and April 2024 have received communications from [email protected] and have been automatically uploaded as users into the new system.
  • Providers who have not received an email will need to request access by emailing [email protected] .
• Fax Completed Morbidity Report Form To: (708) 836-5450.
  • Download and complete the IDPH Morbidity Report Form.
  • View this instructional video for more information on how to complete the Morbidity Report Form.

Test and treat.

Encourage gonorrhea and chlamydia testing in any patients who may be at high risk, including:

1. Gay, bisexual or other men who have sex with men (MSM)
2. Sexually active women under the age of 25 and older women at increased risk.
3. Pregnant women
4. Patients who have multiple partners, new partner(s) or partner(s) with unknown STI/HIV status
5. Patients who use ‘dating’ or ‘hookup’ apps like Jack’d, Grindr, Adam4Adam, Scruff, Tinder, etc.

Comprehensive gonorrhea and chlamydia screening recommended

When screening for gonorrhea and chlamydia, test all exposed sites based on sexual practices. Infections may occur in the throat, rectum, or genitals without symptoms. Site-specific testing (throat swab for oral sex, rectal swab for anal sex, urine or vaginal/cervical swab for genital exposure) ensures accurate diagnosis and prevents missed infections, reinfection, and ongoing transmission (to learn more go to CDC STI Screening Recommendations) .

CDC Test-of-Cure (TOC) recommendations after treating chlamydia and gonorrhea

Chlamydia

• Routine TOC not recommended for most patients treated with first-line regimens.
• Exception: Pregnant individuals should have a test-of-cure about 3–5 weeks post-treatment completion. (Source: cdc.gov) .
• If treatment adherence is in question, symptoms persist, or reinfection is suspected, consider TOC (Source: cdc.gov) .

Gonorrhea

• Uncomplicated infections:
  • Generally, no TOC required after treatment with standard ceftriaxone 500 mg IM. Visit the CDC.gov to learn more .
  • Exception 1: Pharyngeal gonorrhea — TOC recommended with culture or NAAT 7–14 days post-treatment Visit the CDC.gov to learn more .
  • Exception 2: If using non-ceftriaxone regimens, conduct TOC ~4 weeks after treatment

Always follow CDC Treatment Guidelines (includes wall chart and pocket guide) and inform patients to abstain from sexual activity for 7 days after treatment is completed. The CDC STD Tx Guidelines app is available for download on iPhone and Android devices.

Gonorrhea is developing resistance to the antibiotics used to treat it. In fact, we are down to one recommended effective class of antibiotics.

The recommended treatment regimen for uncomplicated gonorrhea is:

• Ceftriaxone 500 mg IM in a single dose
• If chlamydial infection has not been excluded, add doxycycline 100 mg orally 2 times/day for 7 days (CDC)
• Ongoing surveillance and vigilance for treatment failures are crucial due to the evolving nature of antibiotic resistance in gonorrhoeae.
• Retest patients with gonorrhea after 90 days to ensure they are not reinfected.

Chlamydia is the most frequently reported bacterial STI in the U.S. Prevalence is highest in people under the age of 24. Annual screening for females under 24 years old is encouraged.

The recommended treatment regimen for chlamydia is:

• Doxycycline 100 mg orally twice a day for 7 days if not pregnant OR
• Azithromycin 1 gm orally in a single dose if pregnant.

Prevent Reinfection

Prevent reinfection by notifying and treating partners.

Consider Expedited Partner Therapy (EPT)

If a partner of a patient diagnosed with gonorrhea and/or chlamydia cannot be linked to evaluation and treatment in a timely fashion, consider EPT.

EPT is the clinical practice of treating the sex partners of patients diagnosed with chlamydia or gonorrhea by providing prescriptions or medications to the patient to take to his/her partner without the health care provider first examining the partner. EPT is recommended for partners of gonorrhea, as not treating these partners is significantly more harmful than the use of EPT for gonorrhea. Click here for CDC guidelines.

EPT for partners of patients diagnosed with gonorrhea, but not chlamydia:

• Cefixime 800 mg orally in a single dose

EPT for partners of patients diagnosed with both gonorrhea and chlamydia:

• Cefixime 800 mg orally in a single dose + Azithromycin 1g orally in a single dose¹

EPT for partners of patients diagnosed with chlamydia, but not gonorrhea:

• Azithromycin 1g orally in a single dose¹

¹Azithromycin has lower treatment efficacy among persons with rectal chlamydia. Consider Doxycycline 100 mg twice a day for 7 days if there are no  contraindications.

EPT is not routinely recommended for men who have sex with men (MSM) because of a high risk for coexisting infections.

Encourage These Prevention Methods

• Promote safer sex by encouraging your sexually active patients to use condoms consistently and correctly every time they have sex.
• Prescribe when indicated, Doxy PEP as soon as possible but within 72 hours to prevent bacterial STIs after unprotected sexual contact.
• Screen for STIs at follow-up visits.
• Suggest abstinence or limiting sexual partners.

Establish Rapport

Establishing a rapport and taking a patient’s sexual history at every visit in a neutral, non-judgmental manner is key to successful STI testing, treatment, and prevention.

Keep In Mind

Remember, anyone who is sexually active can get gonorrhea and chlamydia.

Contact Us

We want to hear from you. If you have questions about gonorrhea, chlamydia, other STIs, or CDC treatment guidelines, we can help. If you think there’s something we can do better or if you have ideas about how to reduce STIs in our area, please call us at: (708) 836-8699.

• Demian Christiansen, DSc, MPH, Director, Communicable Disease Control and Prevention
• Rachel Rubin, MD, MPH, FAAP, Senior Medical Officer