European guideline for the management of donovanosis, 2010

Abstract

Donovanosis is a rare sexually transmitted infection now mainly seen in sporadic cases in Papua New Guinea, South Africa, India, Brazil and Australia. The causative organism is Calymmatobacterium granulomatis though a proposal has been put forward that the organism be reclassified as Klebsiella granulomatis comb. nov. The incubation period is approximately 50 days with genital papules developing into ulcers that increase in size. Four types of lesions are described – ulcerogranulomatous, hypertrophic, necrotic and sclerotic. The diagnosis is usually confirmed by microscopic identification of characteristic Donovan bodies on stained tissue smears. More recently, polymerase chain reaction (PCR) methods have been developed. The recommended treatment is azithromycin 1 g weekly until complete healing is achieved.

Contemporary unconventional clinical use of co-trimoxazole

“…Although some recurrences and failures were documented in these studies [37], co-trimoxazole is considered to be a second-line choice in the European guidelines for the treatment of donovanosis [38].…”

“…Successful treatment with co‐trimoxazole was documented in the early 1980s, both in a case series [35] and in a prospective study of 116 patients [36]. Although some recurrences and failures were documented in these studies [37], co‐trimoxazole is considered to be a second‐line choice in the European guidelines for the treatment of donovanosis [38].…”

Macrolide Antibiotics

“…Once a positive diagnosis for donovanosis has been made, the current guidelines recommend azithromycin (either 1 g weekly or 500 mg daily) as first-line therapy (O'Farrell and Moi, 2010). Once a positive diagnosis for donovanosis has been made, the current guidelines recommend azithromycin (either 1 g weekly or 500 mg daily) as first-line therapy (O'Farrell and Moi, 2010).…”

Evaluación de mecanismos moleculares de resistencia a fluoroquinolonas en cepas de E. coli uropatógenas en población nativa amerindia kichwa del Ecuador

“…(Bignell et al, 2013). Para el chancroide se considera a ciprofloxacino como segunda línea de tratamiento en algunas guías europeas(Kemp et al, 2011)(STI-Treatment Pocket Guide 2014.Para el granuloma inguinal también se considera el ciprofloxacino como terapia de segunda línea(O´Farrell et al, 2010). Para mycoplasma y ureaplasma se recomienda ofloxacino y levofloxacino.…”