A Randomized, Double-Blind, Placebo-Controlled Trial of Single-Dose Ciprofloxacin versus Erythromycin for the Treatment of Chancroid in Nairobi, Kenya

• Published in: The Journal of infectious diseases Vol. 180; no. 6; pp. 1886 - 1893
• Main Authors: Malonza, Isaac M., Tyndall, Mark W., Ndinya-Achola, Jeckoniah O., Maclean, Ian, Omar, Siad, MacDonald, Kelly S., Perriens, Jos, Orle, Karina, Plummer, Francis A., Ronald, Allan R., Moses, Stephen
• Format: Journal Article
• Language: English
• Published: Chicago, IL The University of Chicago Press 01.12.1999; University of Chicago Press; Oxford University Press
• Subjects: Adolescent; Adult; Aged; Anti-Bacterial Agents - administration & dosage; Anti-Bacterial Agents - therapeutic use; Anti-Infective Agents - administration & dosage; Anti-Infective Agents - therapeutic use; Antibacterial agents; Antibiotics. Antiinfectious agents. Antiparasitic agents; Biological and medical sciences; Chancroid; Chancroid - drug therapy; Chancroid - microbiology; Chancroid - virology; Ciprofloxacin - administration & dosage; Ciprofloxacin - therapeutic use; Double-Blind Method; Erythromycin - administration & dosage; Erythromycin - therapeutic use; Etiology; Female; Genitalia; Haemophilus ducreyi - genetics; Haemophilus ducreyi - isolation & purification; Herpes Genitalis - virology; HIV 1; HIV Infections - complications; Humans; Infections; Kenya; Major Articles; Male; Medical sciences; Men; Middle Aged; Pharmacology. Drug treatments; Polymerase Chain Reaction; Simplexvirus; Simplexvirus - genetics; Simplexvirus - isolation & purification; Syphilis; Syphilis - complications; Syphilis - microbiology; Treatment Outcome; Treponema pallidum - genetics; Treponema pallidum - isolation & purification; Ulcers; Kenya; Africa; Human; Treatment efficiency; Erythromycin; Macrolide; Infection; Pasteurellaceae; Fluoroquinolone derivatives; Antibiotic; Chemotherapy; Sexually transmitted disease; Treatment; Chancroid; Bacteriosis; Bacteria; Clinical trial; Antibacterial agent; Ciprofloxacin; Quinolone derivatives; Haemophilus ducreyi
• ISSN: 0022-1899; 1537-6613
• DOI: 10.1086/315133

A randomized, double-blind, placebo-controlled clinical trial was conducted in Nairobi, Kenya, to compare single-dose ciprofloxacin with a 7-day course of erythromycin for the treatment of chancroid. In all, 208 men and 37 women presenting with genital ulcers clinically compatible with chancroid were enrolled. Ulcer etiology was determined using culture techniques for chancroid, serology for syphilis, and a multiplex polymerase chain reaction for chancroid, syphilis, and herpes simplex virus (HSV). Ulcer etiology was 31% unmixed chancroid, 23% unmixed syphilis, 16% unmixed HSV, 15% mixed etiology, and 15% unknown. for 111 participants with chancroid, cure rates were 92% with ciprofloxacin and 91% with erythromycin. For all study participants, the treatment failure rate was 15%, mostly related to ulcer etiologies of HSV infection or syphilis, and treatment failure was 3 times more frequent in human immunodeficiency virus—infected subjects than in others, mostly owing to HSV infection. Ciprofloxacin is an effective single-dose treatment for chancroid, but current recommendations for empiric therapy of genital ulcers may result in high treatment failure due to HSV infection.