Donovanosis medical therapy: Difference between revisions

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one double-strength (160 mg/800 mg) tablet orally twice a day for at least 3 weeks and until all lesions have completely healed
one double-strength (160 mg/800 mg) tablet orally twice a day for at least 3 weeks and until all lesions have completely healed
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Therapy should be continued at least 3 weeks and until all lesions have completely healed. Some specialists recommend the addition of an aminoglycoside (e.g., gentamicin 1 mg/kg IV every 8 hours) to these regimens if improvement is not evident within the first few days of therapy.
Therapy should be continued at least 3 weeks and until all lesions have completely healed. Some specialists recommend the addition of an aminoglycoside (e.g., gentamicin 1 mg/kg IV every 8 hours) to these regimens if improvement is not evident within the first few days of therapy.



Revision as of 17:32, 30 November 2012

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Kalsang Dolma, M.B.B.S.[2]

Overview

Medical Therapy

A limited number of studies on Donovanosis treatment have been published. Treatment halts progression of lesions, although prolonged therapy is usually required to permit granulation and reepithelialization of the ulcers. Healing typically proceeds inward from the ulcer margins. Relapse can occur 6–18 months after apparently effective therapy. Several antimicrobial regimens have been effective, but a limited number of controlled trials have been published.[1]

Shown below is a table summarizing the preferred and alternative empiric treatment for Donovanosis.[2]
Pathogens Preferred Treatment Duration of Treatment Alternative Treatment
Klebsiella granulomatis Doxycycline

100 mg orally twice a day

For at least 3 weeks and until all lesions have completely healed Azithromycin

1 g orally once per week for at least 3 weeks and until all lesions have completely healed

OR

Ciprofloxacin

750 mg orally twice a day for at least 3 weeks and until all lesions have completely healed

OR

Erythromycin base

500 mg orally four times a day for at least 3 weeks and until all lesions have completely healed

OR

Trimethoprim-sulfamethoxazole

one double-strength (160 mg/800 mg) tablet orally twice a day for at least 3 weeks and until all lesions have completely healed

Therapy should be continued at least 3 weeks and until all lesions have completely healed. Some specialists recommend the addition of an aminoglycoside (e.g., gentamicin 1 mg/kg IV every 8 hours) to these regimens if improvement is not evident within the first few days of therapy.

References

  1. O’Farrell N. Donovanosis. Sex Transmit Infect 2002;78:452–7.
  2. http://www.cdc.gov/std/treatment/2006/genital-ulcers.htm#genulc4


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