Lymphogranuloma venereum medical therapy
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Nate Michalak, B.A.
Overview
Antimicrobial therapy is the mainstay of treatment for lymphogranuloma venerum. Doxycycline 100 mg PO bid for 21 days is the preferred regimen. Alternative regimens include either erythromycin or azithromycin.
Medical Therapy
Successful treatment for LGV cures the infection, resolves the clinical symptoms, and prevents transmission to others. All patients need antimicrobial therapy.
Antimicrobial Regimen
- Lymphogranuloma venereum (LGV) treatment[1]
- Preferred regimen: Doxycycline 100 mg PO bid for 3 weeks
- Alternative regimen: Erythromycin base 500 mg PO qid for 3 weeks
- Note (1): Azithromycin 1 g PO once weekly for 3 weeks is probably effective based on its chlamydial antimicrobial activity. Fluoroquinolone-based treatments might also be effective, but extended treatment intervals are likely required.
- Note (2): Pregnant and lactating women should be treated with Erythromycin. Azithromycin might prove useful for treatment of LGV in pregnancy, but no published data are available regarding its safety and efficacy. Doxycycline is contraindicated in pregnant women but compatible with breastfeeding.
- Note (3): Persons with both LGV and HIV infection should receive the same regimens as those who are HIV negative. Prolonged therapy might be required, and delay in resolution of symptoms might occur.
Follow-Up
Patients should be followed clinically until signs and symptoms resolve.[2]
Treatment of Sex Partners
- Persons who have had sexual contact with a patient who has LGV within the 60 days before onset of the patient’s symptoms should be examined and tested for urethral, cervical, or rectal chlamydial infection depending on anatomic site of exposure
- They should be presumptively treated with a chlamydia regimen (azithromycin 1 g orally single dose or doxycycline 100 mg orally twice a day for 7 days)[2]
References
- ↑ Workowski, Kimberly A.; Bolan, Gail A. (2015-06-05). "Sexually transmitted diseases treatment guidelines, 2015". MMWR. Recommendations and reports: Morbidity and mortality weekly report. Recommendations and reports / Centers for Disease Control. 64 (RR-03): 1–137. ISSN 1545-8601. PMID 26042815.
- ↑ 2.0 2.1 2015 Sexually Transmitted Diseases Treatment Guidelines. Centers for Disease Control and Prevention (June 4, 2015). http://www.cdc.gov/std/tg2015/lgv.htm Accessed February 25, 2016.