Effective treatment of lymphogranuloma venereum with a seven-day course of doxycycline.
Journal
Sexually transmitted diseases
ISSN: 1537-4521
Titre abrégé: Sex Transm Dis
Pays: United States
ID NLM: 7705941
Informations de publication
Date de publication:
06 Mar 2024
06 Mar 2024
Historique:
medline:
11
3
2024
pubmed:
11
3
2024
entrez:
11
3
2024
Statut:
aheadofprint
Résumé
Lymphogranuloma venereum (LGV) remains endemic in the United Kingdom, primarily among gay, bisexual or other men who have sex with men (GBMSM). Current treatment guidelines recommend twenty-one days of doxycycline, but recent evidence suggests shorter antibiotic duration is as effective. We evaluated clinical outcomes in a cohort with LGV treated with seven days of doxycycline. We reviewed case notes of all LGV cases at a South London sexual health service between November 2016 and September 2022, treated with only seven days of doxycycline and anonymised data were collected from electronic patient records. Fifty-two individuals with detected LGV-specific DNA were treated with seven days of doxycycline 100 mg twice daily. All were GBMSM, median age 35 years (range 21-64); 21 (40%) were living with HIV; and 18 (35%) had concomitant sexually transmitted infections.Thirty-four (65%) were asymptomatic, while 18 (35%) reported symptoms: 7 (13%) urethral, 11 (21%) anorectal, and 2 (4%) other symptoms.Twenty-two (42%) were prescribed additional antimicrobials, however none were active against Chlamydia trachomatis.All 52 underwent follow-up testing (range 4 - 481 days); C. trachomatis was detected in one individual, but negative for LGV-specific DNA, and so considered to be a reinfection. All other cases were C. trachomatis negative, indicating successful LGV eradication. Our data support the approach of offering a seven-day doxycycline course routinely for asymptomatic or clinically mild C. trachomatis infections, and contacts of LGV infection, regardless of their LGV status. This may simplify patient management, reduce cost and improve antimicrobial stewardship.
Sections du résumé
BACKGROUND
BACKGROUND
Lymphogranuloma venereum (LGV) remains endemic in the United Kingdom, primarily among gay, bisexual or other men who have sex with men (GBMSM). Current treatment guidelines recommend twenty-one days of doxycycline, but recent evidence suggests shorter antibiotic duration is as effective. We evaluated clinical outcomes in a cohort with LGV treated with seven days of doxycycline.
METHODS
METHODS
We reviewed case notes of all LGV cases at a South London sexual health service between November 2016 and September 2022, treated with only seven days of doxycycline and anonymised data were collected from electronic patient records.
RESULTS
RESULTS
Fifty-two individuals with detected LGV-specific DNA were treated with seven days of doxycycline 100 mg twice daily. All were GBMSM, median age 35 years (range 21-64); 21 (40%) were living with HIV; and 18 (35%) had concomitant sexually transmitted infections.Thirty-four (65%) were asymptomatic, while 18 (35%) reported symptoms: 7 (13%) urethral, 11 (21%) anorectal, and 2 (4%) other symptoms.Twenty-two (42%) were prescribed additional antimicrobials, however none were active against Chlamydia trachomatis.All 52 underwent follow-up testing (range 4 - 481 days); C. trachomatis was detected in one individual, but negative for LGV-specific DNA, and so considered to be a reinfection. All other cases were C. trachomatis negative, indicating successful LGV eradication.
CONCLUSIONS
CONCLUSIONS
Our data support the approach of offering a seven-day doxycycline course routinely for asymptomatic or clinically mild C. trachomatis infections, and contacts of LGV infection, regardless of their LGV status. This may simplify patient management, reduce cost and improve antimicrobial stewardship.
Identifiants
pubmed: 38465962
doi: 10.1097/OLQ.0000000000001963
pii: 00007435-990000000-00337
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
Copyright © 2024 American Sexually Transmitted Diseases Association. All rights reserved.
Déclaration de conflit d'intérêts
No conflicts of interest exist.