Routine presumptive treatment for suspected chlamydia infection has led to overtreatment and should be reviewed in light of rising macrolide resistance, sexual health researchers warn.

They say the practice, recommended since at least 2017, has not only failed to dent chlamydia notifications but could also be causing more harm than good.

Australian STI Management Guidelines currently advise clinicians to “start treatment for patient and sexual partner(s) without waiting for lab results” if there is a high index of suspicion for chlamydia.

But an audit — led by Dr Darren Russell, director of sexual health at Cairns Base Hospital, Queensland — suggests this may need to be balanced with antibiotic stewardship goals.