Chlamydia is treated with antibiotics, and the current first-line medication is doxycycline, taken twice daily for 7 days. This replaced azithromycin (a single-dose option) as the preferred treatment after studies showed doxycycline has higher cure rates, particularly for rectal infections. Both medications are taken by mouth, and chlamydia is fully curable with proper treatment.
Doxycycline: The First-Line Treatment
Doxycycline is the CDC’s recommended treatment for uncomplicated chlamydia in most adults. The standard course is 100 mg taken orally twice a day for 7 days. It’s effective at clearing infections in the genitals, rectum, and throat.
The most common side effects are gastrointestinal: nausea, heartburn, diarrhea, and bloating. Taking it with food and a full glass of water helps reduce stomach irritation. Doxycycline also makes your skin more sensitive to sunlight, so sunburn can happen more easily during treatment. You should avoid lying down for at least 30 minutes after taking it, since the pill can irritate your esophagus.
One important limitation: doxycycline is not safe during the second and third trimesters of pregnancy because it can affect the developing baby’s teeth. It’s also not recommended while breastfeeding.
Azithromycin: The Single-Dose Alternative
Azithromycin used to be the go-to treatment because of its convenience. It’s a single 1-gram dose taken all at once, which eliminates the challenge of remembering to take pills for a full week. It remains an alternative when doxycycline isn’t an option, such as when someone can’t tolerate a 7-day course or has an allergy.
Azithromycin is also the recommended treatment for chlamydia during pregnancy. Clinical experience confirms it is safe and effective for both mother and baby. Erythromycin, an older antibiotic once used in pregnancy, is no longer recommended because its frequent stomach side effects made it hard for people to finish the full course.
Treatment During Pregnancy
Pregnant individuals have fewer antibiotic options. Azithromycin as a single 1-gram oral dose is the standard recommendation. The alternative is amoxicillin, taken three times daily for 7 days, though there are some concerns from lab studies that chlamydia may persist after penicillin-type antibiotics, making it a backup rather than a first choice.
Follow-up testing is especially important during pregnancy. A repeat test roughly 4 weeks after finishing treatment confirms the infection has cleared, and a second retest is recommended 3 months later. Untreated or persistent chlamydia during pregnancy can lead to serious complications for both the mother and newborn, including preterm delivery and infections passed during birth.
What to Expect After Treatment
Most people feel no different during or after treatment because chlamydia often causes no symptoms in the first place. If you did have symptoms like discharge or burning during urination, those typically resolve within a week or two of starting antibiotics. You should avoid sex for 7 days after completing treatment (or 7 days after a single-dose regimen) to prevent passing the infection to a partner.
The CDC recommends retesting 3 months after treatment for everyone diagnosed with chlamydia. This isn’t because the antibiotics failed. It’s because reinfection is common, often from an untreated partner. Repeat infections carry the same risks as the original one, including pelvic inflammatory disease in women and fertility problems over time.
Getting Your Partner Treated
Treating your sexual partner is a critical part of clearing chlamydia for good. If your partner isn’t treated, you can be reinfected as soon as you resume sexual contact. In many states, a practice called expedited partner therapy allows your healthcare provider to write a prescription for your partner without examining them first. You simply bring the medication to your partner directly.
This approach is particularly useful when a partner can’t easily get to a clinic. It doesn’t replace a full evaluation when one is available, but it’s a practical backup that reduces reinfection rates significantly. Your provider can tell you whether expedited partner therapy is legal in your state.
Why Finishing the Full Course Matters
If you’re prescribed the 7-day doxycycline course, finishing every dose matters even if you feel fine (or never felt symptoms at all). Stopping early gives the bacteria a chance to survive and potentially become harder to treat. Chlamydia has not developed widespread antibiotic resistance the way gonorrhea has, and completing treatment as directed helps keep it that way.
If you vomit shortly after taking a dose, contact your provider about whether to retake it. If side effects like nausea are making it hard to finish the course, your provider can switch you to azithromycin instead. The goal is a completed course of whichever antibiotic you can tolerate.