Chlamydia is a common sexually transmitted infection (STI) caused by the bacteria Chlamydia trachomatis. It can infect both men and women and often has no symptoms. If left untreated, chlamydia can cause serious health problems, especially for women. So getting tested and treated is important.
The standard treatment for chlamydia is antibiotics. Usually, a single dose of the antibiotic azithromycin or a week-long course of doxycycline are prescribed. These antibiotics are highly effective at curing chlamydia. However, some people wonder if just 2 pills of antibiotics can clear up chlamydia. Let’s take a closer look at the evidence.
Can 2 pills of antibiotics cure chlamydia?
The short answer is yes, in many cases just 2 pills of the antibiotic azithromycin can cure chlamydia.
Azithromycin is the most commonly prescribed antibiotic for treating chlamydia. The standard dose is a single 1 gram dose, which is taken as two 500mg pills. Multiple studies have shown that this single 2 pill dose of azithromycin cures chlamydia in over 97% of cases, as long as the infection is uncomplicated.
So for most people with uncomplicated chlamydia, those two pills are enough to fully cure the infection. However, there are a few caveats:
Retesting is important
To confirm the treatment worked, follow-up testing is recommended 3 months after finishing treatment. This ensures any repeat infections are caught and retreated. Up to 13% of people can become re-infected within a year if exposed again.
Co-infections may require more treatment
If the chlamydia infection has also caused complications like pelvic inflammatory disease or epididymitis, a longer course of antibiotics may be needed. This ensures the more advanced infection is fully treated.
Partner treatment is essential
Treating sexual partners is critical, even if they have no symptoms. An untreated partner can just reinfect someone even after they’ve been treated.
So while 2 pills of azithromycin may be enough to cure chlamydia itself, additional treatment and follow-ups are usually needed to fully resolve the overall infection.
Why can 2 pills cure chlamydia?
Azithromycin is highly effective at treating chlamydia for two reasons:
1. Azithromycin stays in the body for a long time
Unlike some other antibiotics, azithromycin is taken in a single, large dose. This allows the medication to persist in the body for several days, compared to just a few hours for some other antibiotics.
In fact, azithromycin stays present in genital tissues for 5-7 days after the dose. This lengthy duration helps it thoroughly eliminate chlamydia bacteria.
2. Azithromycin fights the bacteria in multiple ways
Azithromycin has properties that both kill chlamydia bacteria directly and inhibit their ability to multiply. This two-pronged attack helps it more rapidly clear the infection.
Within just a day after the dose, azithromycin reduces chlamydia bacteria counts in the body by nearly 100 times. After three days, the bacteria are essentially undetectable.
So this quick and potent action is why the single 2 pill dose works so well.
Effectiveness by infection site
While azithromycin generally cures chlamydia with just 2 pills, its effectiveness can vary slightly depending on the site of infection:
| Infection Site | 2 Pill Cure Rate |
|---|---|
| Urethra (urethral infection) | ~99% |
| Cervix (cervicitis) | 97-99% |
| Rectum (proctitis) | 90-100%* |
| Throat (pharyngitis) | ~98% |
*Limited data available
As shown, the 2 pill azithromycin regimen cures well over 90% of genital and throat infections. For urethral infections, the cure rate reaches 99%. The slightly lower cure rates for rectal infections may be due to the bacteria being more difficult to eradicate in that location.
Who should take more than 2 pills?
While 2 pills of azithromycin is adequate for most uncomplicated chlamydia cases, some groups may benefit from a longer course:
Pregnant women
Pregnant women with chlamydia may be treated with more than 2 pills of azithromycin or 7 days of amoxicillin to fully clear the bacteria. This helps prevent complications like premature birth.
People with repeat infections
For recurrent infections, a longer course of 7-14 days of doxycycline may be used. This is thought to reduce the risk of a repeat infection.
People with HIV
Due to potential interactions with HIV medications, alternative antibiotics like doxycycline may be used for longer durations.
So in specific cases, more than 2 pills are warranted. But for most people, the single dose azithromycin provides adequate cure rates.
Common antibiotic treatment regimens
Here is a table summarizing the antibiotic treatment options and durations typically used for chlamydia:
| Antibiotic | Standard Dosage | Duration |
|---|---|---|
| Azithromycin | 1 gram (2 pills) | 1 day |
| Doxycycline | 100 mg pills | 7 days |
| Levofloxacin | 500 mg pill | 7 days |
| Erythromycin | 500 mg pills | 7 days |
This outlines the most common antibiotic choices and durations prescribed. While alternative regimens may occasionally be used, azithromycin for 1 day or doxycycline for 7 days are the standard first-line treatments.
What about over-the-counter or natural remedies?
Given how well prescription antibiotics like azithromycin work, over-the-counter and natural remedies are not recommended in place of antibiotic treatment and do not reliably cure chlamydia. Some things touted to treat chlamydia include:
Cranberry juice
There is no evidence cranberry juice is effective at clearing chlamydia or other STDs. It should not replace antibiotics.
Garlic
Garlic has antibacterial properties, but has not been specifically studied for chlamydia. There is no proof it can cure chlamydia infections.
Vitamin C
High-dose vitamin C may slightly shorten the duration of certain infections, but there is no evidence it can cure chlamydia without antibiotics.
While some complementary remedies like probiotics may provide some benefit, antibiotic treatment is imperative to cure chlamydia. Relying solely on natural alternatives is not advised and may worsen the infection.
Can partners take 2 pills too?
If someone is diagnosed with chlamydia, it’s critical for their sexual partners to also get tested and treated. This prevents reinfection.
For partners that test positive too, the 2 pill azithromycin treatment is recommended when the infection is uncomplicated.
However, some doctors may prescribe a 7-14 day course of doxycycline for partners, even when asymptomatic. This longer duration helps clear any undetected co-infections that may be present.
So while 2 pills of azithromycin is effective for most partners, some doctors take a more conservative approach with 7-14 days of antibiotics. The most important thing is that all positive partners get treated.
Common questions
Here are answers to some frequently asked questions about the 2 pill chlamydia treatment:
How quickly does it cure chlamydia?
The 2 pills of azithromycin begin working rapidly, generally curing the infection in 1-3 days. However, it can take up to a week after treatment before an infection is considered fully resolved.
What if you miss a dose?
Missing one of the pills reduces the dose and risks the treatment not being fully effective. Both azithromycin doses are needed to cure chlamydia.
Can you drink alcohol with the pills?
It’s best to avoid alcohol when taking azithromycin, as it may worsen side effects. Heavy drinking may also make the antibiotics less effective.
Does azithromycin have side effects?
Azithromycin is generally well tolerated. Common side effects include mild nausea, diarrhea, abdominal pain and headache. Severe allergic reactions are possible but rare.
Can it treat other STDs too?
A single 2 gram dose of azithromycin may also treat gonorrhea. However, it does not treat other STDs like syphilis, trichomoniasis, genital herpes or HPV.
So in summary, azithromycin as a 2 pill, 1 day treatment works very well for curing uncomplicated chlamydia. While a longer antibiotic course is sometimes needed, the 2 pill regimen is adequate for most people with the infection. However, be sure to get retested in a few months to confirm cure.
Conclusion
For many people with uncomplicated chlamydia, just two 500mg pills of azithromycin is sufficient to cure the infection. This simple single-dose treatment works because azithromycin stays in the body for several days and fights chlamydia bacteria in multiple ways.
However, some groups like pregnant women or people with repeat infections may benefit from a longer 7-14 day antibiotic course. Retesting a few months after treatment is important to confirm the infection has resolved. And remember that sexual partners need treatment too, even if asymptomatic.
While over-the-counter remedies should not replace prescription antibiotics, the good news is that chlamydia is highly curable when treated properly. So if you think you may be infected, get tested and talk to your doctor about the most effective treatment option for you.