[Question #12840] Possible antibiotic resistance?

4 months ago

Dear Doctors,

I am a 28-year-old heterosexual male. I tested positive for chlamydia on March 12, 2025. My doctor prescribed a 7-day course of doxycycline, which I completed without missing a dose. I took each dose at 12-hour intervals, though I may have been 1–2 hours late once or twice. I was diligent about the regimen and did not engage in sexual intercourse during treatment.

It has now been seven days since I finished the course, and I occasionally feel slight itchiness or stinging in my urethra. I have no other symptoms, like discharge or testicular pain. I know I need a test of cure, but I’d appreciate some peace of mind in the meantime. Based on this, here are my questions:

How likely is it that the infection still persists?
If it does persist, what are my next options?
Is there a chance of never fully clearing chlamydia?
If so, what serious complications could arise?

H. Hunter Handsfield, MD

4 months ago

Welcome to our forum. Thank you for your question.

Doxycycline in the standard dose (100 mg twice daily for 7 days) never fails to cure chlamydia -- or so rarely the possibility can be ignored. Slight irregularity in the dosing schedule doesn't matter: as long as you took all 14 doses over 7-10 days, treatment is 100% effective. Symptoms alone never are sufficient to judge presence or absence of chlamydia; only testing is reliable. You don't say what symptoms you had (if any) prior to treatment. If typical, you had discharge from the penis -- probably cloudy or mucus-like -- and perhaps mild discomfort when you urinated. In absence of those symptoms now, you can safely be confident you are cured.

Retesting for chlamydia is not recommended after doxycycline treatment; that's how good the treatment is. Of course you are free to be retested, and the negative result probably would be more reassuring than anything I can say. However, be sure to wait until at least 3 weeks after the last dose of doxycycline. Before that, residual chlamydia RNA can result in a positive test result even though the chlamydia has been eradicated.

To your specific questions:

1. "How likely is it that the infection still persists?" Exceedingly unlikely.

2. Cross the treatment failed bridge if you come to it. For the reasons discussed, you can be confident this won't happen.

3. Almost all chlamydial infections are completely eradicated with doxycycline. There is no such thing as untreatable chlamydia.

4. The main complications of chlamydia in males are epididymitis (testicular infection) and, rarely, a condition called reactive arthritis. The main serious outcomes of chlamydia are in women; it can cause fallopian tube infection (called pelvic inflammatory disease, or PID) and infertility due to blocked tubes.

Your minor continuing symptoms likely will be gone in a few more days. Discuss with the doctor who treated you if they continue behind 7-10 days.

I hope these comments are helpful. Let me know if anything isn't clear.

HHH, MD

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4 months ago

Thank you for your detailed response, Doctor. I believe you have addressed all of my questions thoroughly, and from what I understand, there is no reason to be anxious, as Doxycycline effectively eradicates the infection.

I tend to overthink when it comes to my health, as I’m quite cautious and sensitive to every symptom or change in my body. This has likely contributed to some level of health-related anxiety.

I want to express my sincere gratitude for the work you’re doing. While it may seem like a small gesture, the information and reassurance provided through this platform are incredibly calming and trustworthy. Thank you once again, and please continue the great work.

H. Hunter Handsfield, MD

4 months ago

Thanks for the thanks. i’m glad to have helped. I’ll leave the thread open for a couple more days in case something else related to your chlamydial infection comes to mind.---
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