Warning:

This document is being maintained for historical purposes, but is now out of date. To view current guidelines please visit:

• STD Treatment Guidelines   at http://www.cdc.gov/STD/treatment

---

1993 Sexually Transmitted Diseases Treatment Guidelines

09/24/1993

SUGGESTED CITATION
Centers for Disease Control and Prevention. 1993 Sexually
transmitted diseases treatment guidelines. MMWR 1993;42(No. RR-14):
{inclusive page numbers}.

CIO Responsible for this publication:
National Center for Prevention Services,
Division of Sexually Transmitted Diseases and HIV Prevention

Chlamydial Infections Among Children
     
     Sexual abuse must be considered a cause of chlamydial
infection among preadolescent children, although perinatally
transmitted C. trachomatis infection of the nasopharynx, urogenital
tract, and rectum may persist beyond 1 year (see Sexual Assault or
Abuse of Children). Because of the potential for a criminal
investigation and legal proceedings for sexual abuse, diagnosis of
C. trachomatis among preadolescent children requires the high
specificity provided by isolation in cell culture. The cultures
should be confirmed by microscopic identification of the
characteristic intracytoplasmic inclusions, preferably by
fluorescein-conjugated monoclonal antibodies specific for C.
trachomatis.

Diagnostic Considerations -
     Nonculture chlamydia tests should not be used because of the
possibility of false-positive test results. With respiratory tract
specimens, false-positive test results can occur because of
cross-reaction of test reagents with Chlamydia pneumoniae; with
genital and anal specimens, false-positive test results occur
because of cross-reaction with fecal flora.

Recommended Regimen -
     Children who weigh less than 45 kg

        Erythromycin 50 mg/kg/day divided into four doses for 10-14
        days.

NOTE: The effectiveness of erythromycin treatment is
approximately 80%; a second course of therapy may be required.

     Children who weigh greater than or equal to 45 kg but who are
     less than 8 years of age

        Use the same treatment regimens for these children as the
        adult regimens of erythromycin (see Chlamydial Infections Among
        Adolescents and Adults).

     Children greater than or equal to 8 years of age

        Use the same treatment regimens for these children as the
        adult regimens of doxycycline or tetracycline (see Chlamydial
        Infections Among Adolescents and Adults). Adult regimens of
        azithromycin also may be considered for adolescents.

Other Management Considerations -
     See Sexual Assault or Abuse of Children.

Follow-Up -
     Follow-up cultures are necessary to ensure that treatment has
been effective.

---