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Midwifery: Chlamydia Trachomatis Infection

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Midwifery: Chlamydia Trachomatis Infection Question: Discuss about the Midwifery for Chlamydia Trachomatis Infection.   Answer: Introduction Chlamydia trachomatis infection can be diagnosed by three primary methods. Swab and urine samples are collected from the endocervical canal and the urethra respectively to be used in the lab investigations. The first method of diagnosis is by the use of polymerase chain reaction (PCR) in which the nucleic acids of the causative agent is amplified. Its sensitivity and specificity are as high as 95% and therefore, its results are reliable (Frye, Wallace, Chavez & Luce, 2008). Secondly, the infection can be diagnosed by detection of Chlamydia antigen by ELISA method. Thirdly, it can be diagnosed by culture technique. This technique is the most reliable with a specificity of 100%. However, it is relatively expensive and technically complex than the other techniques. It also takes a longer duration of about 3-7 days for the results to be obtained (Pereboom, Manniën, Rours, Spelten, Hutton & Schellevis, 2014). The recommended antibiotic therapy for pregnant women with the infection is oral amoxicillin 500 mg consumed a day thrice for seven days (Pereboom et al. 2014). Amoxicillin is efficiently absorbed from the gastrointestinal tract with a bioavailability of up to 92% and is secreted renally unchanged.  Amoxicillin is nonteratogenic in humans and is categorized as pregnancy category B drug (Rosenfeld & Loose, 2014). Alternative therapies include 500mg oral intake of erythromycin that is consumed four times per day for seven days, or half of this dose (250mg) can be taken for double the duration (14 days). Its absorption is varied depending on the presence or absence of food in the GI. It crosses the placenta, into breast milk and CSF. It is excreted through the GI tract. About 2-15% of it is excreted through the renal system as unchanged drug. It has no known teratogenic effects in humans but should be used with caution when there are no other alternative therapies (Brenner & Stevens, 2013). Equally, 1 gram of azithromycin can be taken orally as a single dose. It is rapidly absorbed and has a bioavailability of 37%. It is excreted in feces and urine as unchanged drug. It has no teratogenic effects and is categorized as a pregnancy category B drug (Rosenfeld & Loose, 2014).   References Brenner, G. M., & Stevens, C. W. (2013), Pharmacology, Philadelphia, PA: Elsevier/Saunders. Frye, J., Wallace, L., Chavez, R., & Luce, D. (January 01, 2008). Screening and Treatment Guidelines for Chlamydia trachomatis in Incarcerated Adolescents: A Review.Journal of Correctional Health Care, 14, 2, 89-98. Pereboom, M. T. R., Manniën, J., Rours, G. I. J. G., Spelten, E. R., Hutton, E. K., & Schellevis, G. (February 01, 2014). Chlamydia trachomatis infection during pregnancy: Knowledge, test practices, and attitudes of Dutch midwives.Scandinavian Journal of Infectious Diseases,46, 2, 107-113. Rosenfeld, G. C & Loose, D. S. (2014), Pharmacology. Baltimore, MD: Lippincott Williams & Wilkins.

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