From the Guidelines
Chancroid should be treated with a single dose of azithromycin or ceftriaxone as the first-line option. According to the 1998 guidelines for treatment of sexually transmitted diseases by the Centers for Disease Control and Prevention 1, azithromycin and ceftriaxone offer the advantage of single-dose therapy, making them more convenient and potentially improving patient compliance. Some key points to consider when treating chancroid include:
- A single 1-gram dose of azithromycin taken orally is effective for most patients
- Alternatively, a single 250-mg intramuscular injection of ceftriaxone can be used
- For patients who cannot take these medications, other options include ciprofloxacin or erythromycin, however, resistance to these antibiotics has been reported worldwide 1 Treatment should begin promptly after diagnosis to prevent complications and further transmission. The infection typically begins to improve within 3 days of starting treatment, with complete healing occurring within 7-14 days. Patients should abstain from sexual activity until the infection is fully resolved, and sexual partners from the 10 days before symptom onset should also be treated. Pain management with over-the-counter analgesics may be needed while the ulcers heal. If symptoms don't improve within a week, follow-up with a healthcare provider is recommended.
From the FDA Drug Label
Genital ulcer disease (chancroid)One single 1 gram dose Genital ulcer disease in men due to Haemophilus ducreyi (chancroid). Due to the small number of women included in clinical trials, the efficacy of azithromycin in the treatment of chancroid in women has not been established
The recommended antibiotic treatment for chancroid is azithromycin 1 gram as a single dose. However, the efficacy of azithromycin in treating chancroid in women has not been established due to the limited number of women included in clinical trials 2 2. Key points:
- Dosage: 1 gram single dose
- Efficacy in men: established
- Efficacy in women: not established
From the Research
Chancroid Treatment Antibiotic
- Chancroid is a genital ulcerative disease caused by Haemophilus ducreyi, and various antibiotics have been studied for its treatment 3, 4, 5, 6, 7.
- Azithromycin has been shown to be effective in treating chancroid, with a single 1-g oral dose being as effective as a 250-mg im dose of ceftriaxone 3.
- A study comparing azithromycin with erythromycin found that azithromycin, given as a single 1-g oral dose, was an effective treatment for chancroid in men, with cure rates of 89% 4.
- Ciprofloxacin has also been studied as a treatment for chancroid, with a three-day regimen of 500 mg twice daily being effective in eradicating H. ducreyi and resulting in rapid clinical improvement 5.
- Other antibiotics, such as trimethoprim-sulfamethoxazole and amoxicillin-clavulanic acid, have also been used to treat chancroid, although there is limited experience with these drugs in the United States 6.
- Macrolides, including azithromycin, have been found to be effective in treating H. ducreyi infection, with low quality evidence suggesting that azithromycin could be considered as the first therapeutic alternative due to its mono-dose oral administration and similar safety and effectiveness profile compared to long-term erythromycin use 7.
Antibiotic Options
- Azithromycin: 1-g oral dose, single dose 3, 4, 7
- Ceftriaxone: 250-mg im dose, single dose 3
- Ciprofloxacin: 500 mg twice daily, three-day regimen 5
- Erythromycin: 500 mg four times daily, seven-day regimen 4, 6
- Trimethoprim-sulfamethoxazole: 160/800 mg twice daily, seven-day regimen 6
- Amoxicillin-clavulanic acid: 500/125 mg three times daily, seven-day regimen 6