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There are an estimated 12 million new cases of Chlamydia annually in the United States, and STIs in women are responsible for a number of serious sequelae including infertility, chronic pelvic pain, ectopic pregnancy, and other adverse pregnancy outcomes. Primary prevention of STIs and their sequelae through avoidance of infected sex partners and through condom use is the most desirable, pelvic inflammatory disease, herpes, syphilis, condyloma, warts, chlamydia approach, but secondary prevention of STI sequelae through detection and treatment of infected asymptomatic and symptomatic individuals plays an important role as well. Effective prevention requires knowledge of those at risk of infection in order to target interventions in a cost-effective manner. Data on those at risk of STIs come from a variety of sources, including the Centers for Disease Control and Prevention and the U.S. Preventive Services Task Force. The following screening recommendations for sexually transmitted infections in nonpregnant women are derived primarily from publications of the Centers for Control and Prevention and the U.S. Preventive Services Task Force PID, Chlamidia, clamidia.

TABLE 10. Diagnosis and Treatment of Bacterial

Treatment of Chlamydia

Organism Diagnostic Methods Recommended Alternative

Chlamydia trachomatis Cell culture Doxycycline 100 mg orally 2 times a day Ofloxacin 300 mg orally 2 times a day for 7

Direct fluorescent antibody for 7 days or azithromycin 1 g orally in a days or erythromycin base 500 mg orally 4

Enzyme immunoassay single dose times a day for 7 days or erythromycin

Nucleic acid hybridization (DNA probe} ethylsuccinate 800 mg orally 4 times a day for

DNA amplification 7 days.

Polymerase chain reaction

Ligase chain reaction

Neisseria gonorrhoeae Gram stain of endocervical smear Ceftriaxone 125 mg IM in a single dose or Spectinomycin 2 g IM in a