American Board of Internal Medicine (ABIM) Certification Practice Exam

What is the recommended treatment for Chlamydia cervicitis, urethritis, or proctitis?

1. Ciprofloxacin, 500 mg PO

2. Azithromycin, 1 g PO single dose

3. Metronidazole, 500 mg PO

4. Tetracycline, 500 mg PO

The correct answer is: Azithromycin, 1 g PO single dose

The recommended treatment for Chlamydia cervicitis, urethritis, or proctitis is a single dose of Azithromycin, 1 g taken orally. This treatment is preferred due to its effectiveness and the convenience of a single-dose regimen, which can improve adherence, particularly in populations at higher risk for sexually transmitted infections. Azithromycin acts by inhibiting bacterial protein synthesis, making it effective against Chlamydia trachomatis, the causative agent of these infections. The single-dose approach also helps to ensure that patients can complete their treatment without the complications associated with a longer regimen, such as missed doses. While other antibiotics, like ciprofloxacin and tetracycline, may be effective against chlamydia, they are not the first-line treatments due to considerations such as dosing frequency, potential side effects, and resistance patterns. Metronidazole is primarily used to treat infections caused by anaerobic bacteria and certain protozoa and does not target Chlamydia trachomatis effectively. Therefore, Azithromycin remains the treatment of choice in these cases.