A randomized, comparative study undertaken in Nairobi, Kenya and a non
-comparative evaluation undertaken in Carletonville, South Africa have
both shown that a single oral dose of azithromycin Ig is effective in
the treatment of the genital ulcer disease (GUD), chancroid, with cur
e rates of 89% and 92% recorded respectively. While treatment failure
was associated with human immunodeficiency virus seropositivity and la
ck of circumcision in Kenya, no such association could be found in the
South African study. In both series, azithromycin treatment resulted
in cure of both Haemophilus ducreyi culture-positive and culture-negat
ive cases of GUD, including two cases subsequently diagnosed as lympho
granuloma venereum. A combination of single-dose azithromycin with sin
gle-dose benzathine penicillin may provide effective 'single-visit' sy
ndromic treatment for GUD in many developing countries.