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Granuloma Inguinale (Donovanosis) Medication

  • Author: Elizabeth K Satter, MD, MPH; Chief Editor: Dirk M Elston, MD  more...
 
Updated: Oct 20, 2015
 

Medication Summary

The goal of pharmacotherapy for granuloma inguinale is to reduce morbidity and to prevent complications.

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Antibiotics

Class Summary

Empiric antimicrobial therapy must be comprehensive and should cover all likely pathogens in the context of the clinical setting.

Trimethoprim/sulfamethoxazole (Bactrim IV, Bactrim SS, Bactrim DS, Septra)

 

Sulfamethoxazole inhibits the bacterial synthesis of dihydrofolic acid. Trimethoprim reversibly inhibits dihydrofolate reductase and blocks the production of tetrahydrofolic acid from dihydrofolic acid.

Doxycycline (Adoxa, Doryx, Vibramycin, Periostat)

 

Doxycycline is a bacteriostatic tetracycline antibiotic that inhibits protein synthesis and thus bacterial growth by binding to 30S and possibly 50S ribosomal subunits of susceptible bacteria.

Ciprofloxacin (Cipro)

 

Ciprofloxacin is a bactericidal fluoroquinolone antibiotic that inhibits the bacterial enzymes topoisomerase II (DNA gyrase) and topoisomerase IV, which are required for bacterial DNA replication, transcription, repair, and recombination.

Erythromycin (E-Mycin, Ery-Tab, Eryc)

 

Erythromycin is a macrolide antibiotic that inhibits bacterial protein synthesis by binding to the 50S ribosomal subunits of susceptible organisms; it may be bacteriocidal or bacteriostatic depending on the concentration and type of microorganism.

Azithromycin (Zithromax)

 

Azithromycin is an azalide antibiotic (subclass of macrolide antibiotics) that inhibits bacterial protein synthesis by binding to the 50S ribosomal subunits of susceptible organisms; it may be bacteriocidal or bacteriostatic depending on the concentration and type of microorganism.

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Contributor Information and Disclosures
Author

Elizabeth K Satter, MD, MPH Dermatologist and Dermatopathologist

Elizabeth K Satter, MD, MPH is a member of the following medical societies: Alpha Omega Alpha, American Medical Womens Association

Disclosure: Nothing to disclose.

Specialty Editor Board

Richard P Vinson, MD Assistant Clinical Professor, Department of Dermatology, Texas Tech University Health Sciences Center, Paul L Foster School of Medicine; Consulting Staff, Mountain View Dermatology, PA

Richard P Vinson, MD is a member of the following medical societies: American Academy of Dermatology, Texas Medical Association, Association of Military Dermatologists, Texas Dermatological Society

Disclosure: Nothing to disclose.

Paul Krusinski, MD Director of Dermatology, Fletcher Allen Health Care; Professor, Department of Internal Medicine, University of Vermont College of Medicine

Paul Krusinski, MD is a member of the following medical societies: American Academy of Dermatology, American College of Physicians, Society for Investigative Dermatology

Disclosure: Nothing to disclose.

Chief Editor

Dirk M Elston, MD Professor and Chairman, Department of Dermatology and Dermatologic Surgery, Medical University of South Carolina College of Medicine

Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

Additional Contributors

James J Nordlund, MD Professor Emeritus, Department of Dermatology, University of Cincinnati College of Medicine

James J Nordlund, MD is a member of the following medical societies: American Academy of Dermatology, Sigma Xi, Society for Investigative Dermatology

Disclosure: Nothing to disclose.

Jerry J Fasoldt, MD Head of Medical Department, Senior Flight Surgeon, Naval Operational Support Center

Jerry J Fasoldt, MD is a member of the following medical societies: Society of US Naval Flight Surgeons

Disclosure: Nothing to disclose.

Acknowledgements

The authors and editors of Medscape Reference gratefully acknowledge the contributions of previous authors, Clara-Dina Cokonis, Steven M. Manders, and Kari Williamson Boucher to the development and writing of this article. We also thank Hon Pak for the use of his clinical pictures.

References
  1. Carter JS, Bowden FJ, Bastian I, Myers GM, Sriprakash KS, Kemp DJ. Phylogenetic evidence for reclassification of Calymmatobacterium granulomatis as Klebsiella granulomatis comb. nov. Int J Syst Bacteriol. 1999 Oct. 49 Pt 4:1695-700. [Medline].

  2. Anderson K. The Cultivation From Granuloma Inguinale of a Microorganism Having the Characteristics of donovan bodies in the yolk sac of chick embryos. Science. 1943 Jun 18. 97(2529):560-561. [Medline].

  3. Velho PE, Souza EM, Belda Junior W. Donovanosis. Braz J Infect Dis. 2008 Dec. 12(6):521-5. [Medline].

  4. Barroso LF, Wispelwey B. Donovanosis presenting as a pelvic mass mimicking ovarian cancer. South Med J. 2009 Jan. 102(1):104-5. [Medline].

  5. Taneja S, Jena A, Tangri R, Sekhon R. Case report. MR appearance of cervical donovanosis mimicking carcinoma of the cervix. Br J Radiol. 2008 Jun. 81(966):e170-2. [Medline].

  6. [Guideline] British Association for Sexual Health and HIV (BASHH). Donovanosis (granuloma inguinale). In: Sexually transmitted infections: UK national screening and testing guidelines. National Guidelines Clearinghouse. 2011 Aug. [Full Text].

  7. [Guideline] Centers for Disease Control and Prevention. 2015 Sexually Transmitted Diseases Treatment Guidelines-Granuloma inguinale (Donovanosis). Available at http://www.cdc.gov/std/tg2015/donovanosis.htm. June 4, 2015; Accessed: October 19, 2015.

  8. Rosen T, Vandergriff T, Harting M. Antibiotic use in sexually transmissible diseases. Dermatol Clin. 2009 Jan. 27(1):49-61. [Medline].

  9. Workowski KA, Bolan GA, Centers for Disease Control and Prevention. Sexually transmitted diseases treatment guidelines, 2015. MMWR Recomm Rep. 2015 Jun 5. 64 (RR-03):1-137. [Medline].

  10. Kallen BA, Otterblad Olausson P, Danielsson BR. Is erythromycin therapy teratogenic in humans?. Reprod Toxicol. 2005 Jul-Aug. 20(2):209-14. [Medline].

  11. Murase JE, Heller MM, Butler DC. Safety of dermatologic medications in pregnancy and lactation: Part I. Pregnancy. J Am Acad Dermatol. 2014 Mar. 70 (3):401.e1-14; quiz 415. [Medline]. [Full Text].

  12. Manders SM, Baxter JD. Granuloma inguinale and HIV: a unique presentation and novel treatment regimen. J Am Acad Dermatol. 1997 Sep. 37(3 Pt 1):494-6. [Medline].

  13. Chandra Gupta TS, Rayudu T, Murthy SV. Donovanosis with auto-amputation of penis in a HIV-2 infected person. Indian J Dermatol Venereol Leprol. 2008 Sep-Oct. 74(5):490-2. [Medline].

  14. Sardana K, Garg VK, Arora P, Khurana N. Malignant transformation of donovanosis (granuloma inguinale) in a HIV-positive patient. Dermatol Online J. 2008 Sep 15. 14(9):8. [Medline].

  15. Bowden FJ. Donovanosis in Australia: going, going... Sex Transm Infect. 2005 Oct. 81(5):365-6. [Medline].

  16. Sardana K, Garg VK, Arora P, Khurana N. Malignant transformation of donovanosis (granuloma inguinale) in a HIV-positive patient. Dermatol Online J. 2008. 14(9):8. [Medline].

 
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Beefy-red penile ulcers.
Courtesy of Hon Pak, MD.
Courtesy of Hon Pak, MD.
Courtesy of Hon Pak, MD.
 
 
 
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