Treatment of Lymphogranuloma Venereum (LGV)
A 21-day course of doxycycline 100 mg twice daily is the recommended treatment for lymphogranuloma venereum, not a 1-gram daily dose of azithromycin for two weeks. Your current treatment regimen is inadequate for LGV.
Correct Treatment for LGV
- The standard treatment for lymphogranuloma venereum is doxycycline 100 mg orally twice daily for 21 days 1, 2
- Azithromycin can be effective for LGV, but requires an extended regimen of 1 g orally once weekly for 3 weeks, not daily administration 1
- Your current regimen of 1 gram azithromycin daily for two weeks is not a recognized treatment protocol for LGV and may lead to treatment failure 1
Diagnosis Clarification
- A Bartholin's cyst is not the same as lymphogranuloma venereum (LGV) 3
- Bartholin's cysts are typically treated with incision and drainage if symptomatic, not with antibiotics alone 3
- Standard chlamydia treatment (azithromycin 1g single dose or doxycycline 100mg twice daily for 7 days) is adequate for uncomplicated genital chlamydia but insufficient for LGV 3, 4
Recommended Course of Action
- Both you and your partner should be evaluated by a healthcare provider to confirm the diagnosis 5
- If LGV is confirmed, the correct treatment is:
Follow-Up Recommendations
- Clinical cure (resolution of symptoms) should be expected by 6 weeks after proper treatment 1
- A test of cure is not routinely recommended if symptoms resolve with appropriate therapy 5
- Both partners should abstain from sexual activity until treatment is completed and symptoms have resolved 5
Important Considerations
- Recent research suggests that a 7-day course of doxycycline may be effective for mild or asymptomatic LGV, but this is not yet incorporated into guidelines 2
- Reinfection is common if sexual partners are not adequately treated 5
- If symptoms persist after appropriate treatment, reevaluation is necessary to rule out reinfection or treatment failure 5