ABX for Chlamydia

[The White Coat Investor]

So I was treating a lady for chlamydia cervicitis (presumed of course) yesterday and she is pregnant. She is also allergic to macrolides. So while looking for an alternative to quinolones, tetracyclines, and macrolides, I discovered that the CDC recommendations and the Sanford guide recommend amoxicillin. Recalling from the remote past that chlamydia is an obligate intracellular organism without a cell wall, I became confused as to the mechanism of how amoxicillin (a beta-lactamase drug) would be useful against chlamydia.

Am I missing something?

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[stoic]

though it's not well understood, b-lactams do actually inhibit the growth of chlamydia. the organism produces proteins termed "penicillian binding proteins" which do just that - and presumably also serve some function necessary for the growth/survival of the bacteria which is inhibited when bound to penicillians.

 

[iliacus]

So I was treating a lady for chlamydia cervicitis (presumed of course) yesterday and she is pregnant. She is also allergic to macrolides. So while looking for an alternative to quinolones, tetracyclines, and macrolides, I discovered that the CDC recommendations and the Sanford guide recommend amoxicillin. Recalling from the remote past that chlamydia is an obligate intracellular organism without a cell wall, I became confused as to the mechanism of how amoxicillin (a beta-lactamase drug) would be useful against chlamydia.

Am I missing something?

Great question...John Hopkins ABX guide said to use the following in pregnant patients.

Recommended regimen: Amoxicillin 500 mg PO tid x 7d (Test of cure required 3 wks after end of Rx)


Didn't say anything about the mechanism. Hopefully next year some sinister attending will try to pimp me on this