Can Amoxicillin Be Used To Treat Chlamydia?

In our latest question and answer, the pharmacist discusses whether or not amoxicillin is used to treat chlamydia infections.

Nov 22, 2019

Josh asked

Hello, Can I take amoxicillin 1000mg once a day for 5 days to treat a chlamydia infection? Thanks and kind regards.

At a glance

  • Amoxicillin is not a recommended treatment for chlamydia infections. Azithromycin and doxycycline are first-line therapies.
  • In pregnant women, amoxicillin is an alternative treatment option, after azithromycin.


Amoxicillin Capsules

According to the 'Sexually Transmitted Diseases Treatment Guidelines' from the CDC (Centers for Disease Control), amoxicillin is not a recommended therapy for the treatment of chlamydia, at least not for most individuals.

There are two recommended regimens for the treatment of chlamydia infections:

If these drugs are not an option for you (e.g. due to an allergy), there are four recommended alternative treatments:

  • Erythromycin (base) 500 mg four times daily for 7 days
  • Erythromycin ethylsuccinate four times daily for 7 days
  • Levofloxacin 500 mg once daily for 7 days
  • Ofloxacin 300 mg twice daily for 7 days

These recommendations are summarized in a chart below, provided by the CDC:

Chlamydia Treatment CDC Recommendation Chart

Source: CDC

There doesn't appear to be much, if any, difference between azithromycin and doxycycline in terms of their effectiveness.

One 2002 study concluded the following:

"Azithromycin and doxycycline are equally efficacious in achieving microbial cure and have similar tolerability. Further head-to-head trials comparing these antibiotics are unnecessary."

Another study, completed in 2015, reported that doxycycline had a cure rate of 100% in their test subjects while azithromycin came in at 97%.

Does Amoxicillin Fit In Anywhere?

As stated, amoxicillin is not a recommended therapy for chlamydia infections.

This is because several studies have reported that penicillin-family antibiotics (which include amoxicillin) may not effectively eradicate a chlamydia infection, which may then persist after a course of antibiotics is completed (causing reinfection).

Azithromycin is still the preferred treatment during pregnancy.

However, the CDC states that amoxicillin is an option for pregnant women since doxycycline is contraindicated (i.e. should not be used) during the second and third trimester and quinolone antibiotics (e.g. levofloxacin and ofloxacin) may cause cartilage damage in infants.

If amoxicillin is used in a pregnant woman, the dose recommendation is as follows:

  • Amoxicillin 500 mg three times a day for 7 days

Recommendations for the treatment of chlamydia in pregnant women is summarized below in a chart provided by the CDC:

Chlamydia Treatment Pregnancy Recommendations Chart

Source: CDC

  1. Chlamydial Infections. PubMed
  2. Azithromycin versus doxycycline for genital chlamydial infections: a meta-analysis of randomized clinical trials. PubMed
  3. Chlamydia trachomatis Persistence in Vitro – An Overview. PubMed
  4. Chlamydia muridarum enters a viable but non-infectious state in amoxicillin-treated BALB/c mice. PubMed
  5. Azithromycin versus Doxycycline for Urogenital Chlamydia trachomatis Infection. PubMed

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