Prioritising meaningful outcomes in the practice evaluation of new chlamydia testing guidelines—Authors’ reply

We thank Alexiou and Dukers-Muijrers for their interest in our publication on the estimated impact of the Dutch guideline change reducing asymptomatic Chlamydia trachomatis (CT) testing on the number of diagnoses. 1,2 This guideline change represents a shift from infection management to a disease management approach. 3 Our study presented a counterfactual scenario estimating the potential reduction in antibiotic use for CT if the guideline change had been implemented between 2015 and 2023. Our estimations are not intended to reflect real-world conditions, including variability in guideline adherence, but rather to illustrate the potential scale of impact of the revised guideline. This underscores the importance of monitoring and surveillance, especially sexually transmitted infection (STI) prevalence, STI-associated complications, transmission dynamics, and testing behaviour of clients. The revised guideline restricts testing to individuals with