How is chancroid treated?

Updated: Aug 05, 2019
  • Author: Joseph Adrian L Buensalido, MD; Chief Editor: Pranatharthi Haran Chandrasekar, MBBS, MD  more...
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Answer

Treatment should be started as soon as the diagnosis of chancroid is suspected on clinical grounds owing to the lack of appropriate, fast, and sensitive laboratory tests.

The presence of an STI has long been recognized as a risk factor for the acquisition of an additional STI. Patients presenting with suspected or diagnosed chancroid should undergo complete evaluation for other possible concomitant STDs and receive appropriate antimicrobial therapy for the eradication of H ducreyi and the treatment of other more common STDs. The syndromic approach to the treatment of STIs was adopted because of the presence of coinfections with other STIs and HIV. [48]

Appropriate treatment of chancroid cures the infection, reduces the complications, and prevents transmission. The CDC’s 2015 Sexually Transmitted Diseases Treatment Guidelines and the UK National Guideline for the management of chancroid recommends the following antibiotic options: [49]

  • Azithromycin - 1 g orally (PO) as a single dose or
  • Ceftriaxone - 250 mg intramuscularly as a single dose or
  • Erythromycin base - 500 mg PO 3 times daily for 7 days or
  • Ciprofloxacin - 500 mg PO twice daily for 3 days

Azithromycin and ceftriaxone as single-dose treatments have the advantage of observed compliance.

Ceftriaxone is the treatment of choice in pregnant women, although data have suggested that ciprofloxacin presents a low risk to the fetus during pregnancy with potential toxic effects during breastfeeding. [50]

Sexual partners of patients with chancroid should be examined and treated regardless of the presence of symptoms if they had sexual contact within 10 days preceding the onset of symptoms.


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