LOW-DOSE ERYTHROMYCIN REGIMEN FOR THE TREATMENT OF CHANCROID

Haemophilus ducreyi is the commonest cause of genital ulcer disease in Africa and is associated with heterosexual transmission of human immu nodeficiency virus(HIV). The World Health Organization currently recom mends erythromycin 500mg three times a day for seven days as the treat ment of choice for Haemophilus ducreyi infection, We studied the effec tiveness of a lower dose erythromycin treatment regime, 250 mg three t imes a day for seven days in the treatment of chancroid, Patients with genital ulcer disease presenting at Nairobi City council clinic betwe en January and March, 1992 were recruited into the study, Swabs were t aken from the ulcers for Haemophilus ducreyi and venous blood was scre ened for syphilis and HN antibodies. A total of 219 patients were enro lled for the study and were reviewed on days seven and fourteen for si de effects, bacteriological and clinical cure rates. 26.4% of the stud y population were HIV-1 seropositive. The treatment regime was well to lerated and effective in both HIV seropositive and seronegative patien ts, Complete bacteriological cure rate was achieved in Haemophilus duc reyi culture positives by day seven irrespective of the HIV serostatus , However, the clinical cure rate for HIV seropositive patients was 88 % compared to 99% for seronegative patients (p<.001). It is concluded that a low dose erythromycin is an inexpensive and effective treatment for chancroid with complete bacteriological cure rate, although the h ealing process takes longer in HIV seropositive patients.