Screening and Treatment of Sexually Transmitted
Screening for Chlamydia trachomatis is imperative. In a 2005 study, 7.7% of women tested positive pre termination
of pregnancy.3 Untreated Chlamydia is associated with significant post-op morbidity, including endometritis,
salpingitis and pelvic inflammatory disease.
A endocervical swab for a PCR test for Chlamydia is the gold standard as there is a high false negative rate with
urine tests for Chlamydia in women.
Screening for Neisseria gonorrhoea is mandatory and should be done on a separate endocervical swab then transported
to the laboratory as soon as possible. There is approximately a 50% loss of viable organisms if it takes more than
24 hrs before the sample gets to the laboratory.
Most laboratories are able to check for other infections such as Trichomonas vaginalis and Bacterial vaginosis on
the same swab, if not then send a third swab (high vaginal).
If any swabs come back as positive for infection, it is important that the GP make contact with the woman and arrange
for immediate treatment for both the woman and her partner(s).
Treatment for Chlamydia: Azithromycin 1 g stat (certified condition)
Treatment for Gonorrhoea: If penicillin susceptible use Amoxycillin 3 g and Probenecid 1 g stat
. If Ciprofloxacin susceptible use Ciprofloxacin 500 mg stat. If Ciprofloxacin resistant use Ceftriaxone 250 mg IM.
When treating Gonorrhoea infection, treatment regimens should include treatment for Chlamydia as well, as co-infection
Treatment for Bacterial vaginosis /Gardnerella vaginalis /Trichomonas (both confirmed or
indeterminant): Ornidazole 1.5 g stat, or tinidazole 2 g stat or Metronidazole 2 g stat or 400 mg tds for 7 days
Some clinics consider giving treatment for Group B Streptococcus agalactiae where cultured. Contact your local clinic
Advise the woman not to have sexual intercourse until she has been seen at clinic as re-infection can cause
unnecessary delays in any procedures.