Background Rates of up to 30% Neisseria gonorrhoeae (NG) and Chlamydia trachomatis (CT) co-infection occur in men. Historically, Men who have Sex with Men (MSM) were considered to have a low incidence of CT. However, increasing prevalence of CT and NG in MSM, especially asymptomatic anorectal infection is a reality. Despite well-established guidelines providing presumptive co-treatment for CT to patients with treatment indications for NG, various centers in Australia differ in their approach to management in MSM. At our Clinic, epidemiological treatment for CT had only been given to heterosexual males with a presumptive diagnosis of urethral gonorrhoea.

Aim This study was to determine if the local prevalence of CT co-infection in MSM justifies epidemiological treatment when a presumptive diagnosis of urethral gonorrhoea is made.

Methods A retrospective review of case notes data, analysed for NG and CT co-infection in male patients was made over a 10-year period from 2001 to 2010. Data analysis was performed using STATA (V.10).

Results The proportion of heterosexual males who were NG smear positive and also found to be CT positive was 33/274 (12%) CI 8.4% to 16.5%. The proportion of MSM who were NG smear positive and found to be CT positive as well was 22/207 (13.4%) CI 9% to 18.8%.

Conclusion Based on this study, the guidelines at our Clinic were changed. All MSM with a presumptive diagnosis of NG infection are now given epidemiological treatment for CT infection as heterosexual men.