Chlamydia conundrum

A surprising repeat diagnosis raises questions about antibiotic resistance and reinfection

Lauren is a 21-year-old woman who presents to your practice for a routine Pap smear. Six months earlier, she had Chlamydia trachomatis screening as recommended by RACGP guidelines.


At that time, chlamydia PCR was positive on first pass urine. She was given a stat dose of 1g azithromycin orally. Her long-term male partner was also treated with a stat dose of 1g azithromycin orally by his GP.

Lauren has remained asymptomatic. She uses Implanon for contraception, with no condom use. Both Lauren and her partner are reportedly monogamous. She has no other medical