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.

Find the latest Cook County STI surveillance report (2023).

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

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.