Reactive arthritis
ICD-10 M02.3 · ICD-11 FA11.2

Treatment of Reactive Arthritis in Chlamydia trachomatis Genitourinary Infection

Reactive arthritis (ReA) can develop following a genitourinary infection. Identifying and addressing the triggering pathogen is central to managing this condition.

Chlamydia trachomatis genitourinary infection is the most common agent triggering reactive arthritis after a genitourinary infection. This scenario requires a management approach that accounts for both the underlying infection and the associated inflammatory arthritis.

Treatment approach

Management involves antibiotic therapy directed at the genitourinary infection, with the possibility of an extended antibiotic course in cases of acute Chlamydia-induced reactive arthritis. Partner management is also a key component. The complete structured regimen is in the full protocol.

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References

  1. The most common agent triggering ReA after a genitourinary infection is Chlamydia trachomatis, whereas Shigella, Salmonella, Yersinia and Campylobacter are the most common involved agents in gastroenteric-associated disease.
  2. Currently, a non-gonococcal genitourinary infection needs to be treated with azithromycin 1 gr in a single administration or doxycycline 100 mg twice a day for 7 days, regardless of the presence of arthritis.
  3. Sexual partners should be treated simultaneously, and patients should be advised about the risk of relapse in case of re-infection and about specific preventive measure to avoid it.
  4. In patients with acute Chlamydia-induced ReA, the high prevalence of re-infections within the first 3 months suggests a longer antibiotic course (4 to 12 weeks) either with doxycycline or ciprofloxacin.
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