Intravenous Single-Dose Ceftriaxone Treatment of Chancroid

Abstract

The antimicrobial susceptibility of Haemophilus ducreyi varies according to the geographic region. Increased resistance to trimethoprim and/or sulfamethoxazole led the Centers for Disease Control to recommend 250 mg ceftriaxone as a single intramuscular dose for chancroid. Intravenous or muscular routes of administration result in equivalent bioavailability. To avoid side effects such as syringe abscess and lidocaine intolerance, we prefer intravenous ceftriaxone therapy. The efficacy of this regimen is reported in 3 cases of chancroid. The intravenous administration of 1 g of ceftriaxone in chancroid seems to be as effective as administration by the intramuscular route, but it may lower the risk of syringe abscess, lidocaine intolerance and the emergence of resistant strains.

Genital ulcer disease and human immunodeficiency virus: a focus

“…Both single‐dose flexoxacin and quinolone therapy for 5 days have been found to be less effective in HIV‐positive patients 59,104 . Single‐dose ceftriaxone and single‐dose azithromycin have also demonstrated significant failure rates in HIV‐positive chancroid patients 59,98,105 . Because data are limited concerning the efficacy of azithromycin and ceftriaxone regimens in HIV patients, these regimens should be used if follow‐up can be ensured 59,80 .…”

Genital ulcer disease and human immunodeficiency virus: a focus

“…59,104 Single-dose ceftriaxone and singledose azithromycin have also demonstrated significant failure rates in HIV-positive chancroid patients. 59,98,105 Because data are limited concerning the efficacy of azithromycin and ceftriaxone regimens in HIV patients, these regimens should be used if follow-up can be ensured. 59,80 Some experts recommend using 2 g of erythromycin base in four equally divided dosages daily over 7 days for treating HIV-positive patients.…”

Chancroid: contemporary appraisal

“…However, in patients where concomitant infection of H. ducreyi and HIV is diagnosed, a longer course of therapy and close monitoring are mandatory 78-80 · A number of antibiotics have since been tried in the preceding eventful decade, with capricious success. [79][80][81][82][83][84][85][86][87][88][89] Prominent amongst them are flexoxacin, which is useful both in HIV-1 sero-positive and sero-negative individuals with chancroid, 83 with a recorded 35% failure of ceftriaxone in HIV-1 positive patients; 84 a single i.m. 2-g dose of spectinomycin is also safe and effective, 85 as is three doses of enoxacin 400 mg at 12-h intervals.…”

“…A number of antibiotics have since been tried in the preceding eventful decade, with capricious success 79–89 . Prominent amongst them are flexoxacin, which is useful both in HIV‐1 sero‐positive and sero‐negative individuals with chancroid, 83 with a recorded 35% failure of ceftriaxone in HIV‐1 positive patients; 84 a single i.m. 2‐g dose of spectinomycin is also safe and effective, 85 as is three doses of enoxacin 400 mg at 12‐h intervals 86 .…”