Per the CDC guidelines for chlamydial infections, an NAAT can be used for test-of-cure if performed 3 to 4 weeks after the end of treatment.4 This is appropriate when therapeutic adherence is in question, symptoms persist, or reinfection is suspected.4 Testing earlier than 3 to 4 weeks after treatment may produce a clinically false-positive result due to detection of nucleic acids from nonviable organisms.6
For patients with urogenital or rectal gonorrhea, follow-up testing is not needed to prove eradication after treatment with any of the recommended or alternative regimens. However, if symptoms persist, the patient should be evaluated using N gonorrhoeae culture (with or without simultaneous NAAT), and any gonococci isolated should be tested for antimicrobial susceptibility. Any person with pharyngeal gonorrhea who is treated with an alternative regimen should return 14 days after treatment for a follow-up with either culture or NAAT. If the NAAT is positive, a confirmatory culture is recommended before retreatment. If the culture is positive, antimicrobial susceptibility testing is recommended.
Routine follow-up testing after chlamydia or gonorrhea therapy can be performed using an NAAT approximately 3 months after treatment. If retesting at 3 months is not possible, clinicians should retest at the next opportunity within the 12-month period following initial treatment.