Don’t forget contraception

The review of Chlamydia trachomatis infections does not mention the potential interaction between antibiotics and combined hormonal contraception.1 The national chlamydia screening programme in England is aimed at all sexually active young people aged 15-24, and 54% of women aged 20-24 take the contraceptive pill.2 Thus a large proportion of the women diagnosed through the screening programme will be using combined hormonal contraception. The Faculty of Sexual and Reproductive Health Care states that women using such contraception should be advised to use additional precautions when taking short term antibiotics because they may reduce the efficacy of the contraception.3 Abortion rates are highest among those aged 20-24 (32 per 1000 women) but peak at the age of 19 (36 per 1000)4: there is no room for complacency about the risks associated with contraceptive failure.

The national strategy for sexual health and HIV aims to reduce the prevalence of undiagnosed sexually transmitted infections and rates of unintended pregnancy.5 Both aims must be remembered. When treating chlamydia, ask women if they are using combined hormonal contraception and if so advise them to avoid sexual contact to prevent not only re-infection but also potential pregnancy.