Chlamydia trachomatis and non-gonococcal urethritis

Chlamydia is a common sexually transmitted infection (STI) in young people. It is often asymptomatic, but untreated infection can have significant long-term complications that may present to non-sexual health specialities. These include pelvic inflammatory disease (PID) and infertility in women. Current diagnostic techniques are sensitive and highly specific and are approved for patient-taken samples. This means non-specialist settings are well placed to diagnose and treat chlamydia in individuals from high-risk groups who may not access hospital-based healthcare services. The English National Chlamydia Screening Programme (NCSP) aims for all sexually active young men and women under the age of 25 to be aware of chlamydia and its effects, and have access to services providing screening, prevention and treatment, but there remains debate about its cost-effectiveness. Testing for chlamydia should be used as an opportunity to screen for other STIs including gonorrhoea, HIV and syphilis where indicated and also as a chance to offer advice for those engaging in high-risk sexual behaviour. Non-gonococcal urethritis is an important cause of urethral discharge and dysuria in men and is usually sexually transmitted. However, it can occur in stable relationships and in 30% no micro-organism is detected. Diagnosis and treatment are best undertaken in a specialist sexual health centre, although management is possible in a community setting. There is debate about the efficacy of current recommended treatments and national guidelines should be consulted for up-to-date antibiotic regimens.