Antimicrobial therapy of chancroid: an evaluation of five treatment regimens correlated with in vitro sensitivity.
One hundred fifty-one men with genital ulcer disease were assigned randomly to treatment with one of five oral antimicrobial regimens: (1) sulfadimidine (1 g four times daily for seven days); (2) tetracycline (500 mg four times daily for seven days); (3) trimethoprim-sulfamethoxazole (TMP-SMZ; 160 mg of TMP and 800 mg of SMZ twice daily for seven days); (4) doxycycline (300 mg as a single dose); or (5) TMP-sulfametrole (640 mg of TMP and 3,200 mg of sulfametrole once as a single dose). Haemophilus ducreyi was isolated from 81 (54%) of the men, and 35 strains were available for testing of antimicrobial susceptibility. The TMP-SMZ and TMP-sulfametrole regimens were more effective than sulfadimidine, tetracycline, or single-dose doxycycline in curing ulcers. Only one of 35 strains tested was susceptible to tetracycline (less than or equal to 8 mg/liter), and only ten of 35 strains were susceptible to doxycycline (less than or equal to 4 mg/liter), whereas all were susceptible to trimethoprim (less than or equal to 2 mg/liter). The correlation between in vitro susceptibility and bacteriologic response to the antimicrobial agents requires further investigation. In particular, sulfonamide resistance did not always identify failure to respond to sulfadimidine.
D002602:Chancroid / Q000188:drug therapy*; D004318:Doxycycline / Q000494:pharmacology / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D006191:Haemophilus ducreyi / Q000187:drug effects; D006801:Humans; D066298:In Vitro Techniques; D008297:Male; D013045:Species Specificity; D013418:Sulfamethazine / Q000494:pharmacology / Q000627:therapeutic use*; D013420:Sulfamethoxazole / Q000494:pharmacology / Q000627:therapeutic use*; D013424:Sulfanilamides / Q000494:pharmacology / Q000627:therapeutic use*; D013752:Tetracycline / Q000494:pharmacology / Q000627:therapeutic use*; D014295:Trimethoprim / Q000494:pharmacology / Q000627:therapeutic use*
D013424:Sulfanilamides; D013418:Sulfamethazine; D014295:Trimethoprim; C012047:sulfametrole; D013752:Tetracycline; D013420:Sulfamethoxazole; D004318:Doxycycline