Granuloma Inguinale (Donovanosis) Medication

  • Author: Jerry J Fasoldt, MD; Chief Editor: Dirk M Elston, MD   more...
 
Updated: Aug 5, 2011
 

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.

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

 

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

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Doxycycline (Adoxa, Doryx, Vibramycin, Periostat)

 

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

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Ciprofloxacin (Cipro)

 

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.

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

 

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

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Azithromycin (Zithromax)

 

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

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Contributor Information and Disclosures
Author

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 United States Naval Flight Surgeons

Disclosure: Nothing to disclose.

Coauthor(s)

Elizabeth Kline Satter, MD, MPH  Chairman, Department of Dermatology, Naval Medical Center San Diego

Elizabeth Kline Satter, MD, MPH is a member of the following medical societies: Alpha Omega Alpha and American Medical Women's Association

Disclosure: Nothing to disclose.

Specialty Editor Board

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, and Society for Investigative Dermatology

Disclosure: Nothing to disclose.

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, Association of Military Dermatologists, Texas Dermatological Society, and Texas Medical Association

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, and Society for Investigative Dermatology

Disclosure: Nothing to disclose.

Catherine M Quirk, MD  Clinical Assistant Professor, Department of Dermatology, University of Pennsylvania

Catherine M Quirk, MD is a member of the following medical societies: Alpha Omega Alpha and American Academy of Dermatology

Disclosure: Nothing to disclose.

Chief Editor

Dirk M Elston, MD  Director, Ackerman Academy of Dermatopathology, New York

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

Disclosure: Nothing to disclose.

Acknowledgments

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. Oct 1999;49 Pt 4:1695-700. [Medline].

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

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

  4. Barroso LF, Wispelwey B. Donovanosis presenting as a pelvic mass mimicking ovarian cancer. South Med J. Jan 2009;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. Jun 2008;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. Aug 2006.

  7. Sulfamethoxazole and trimethoprim [package insert]. Irvine, Calif: Sicor Pharmaceuticals; 2003.

  8. Bowden FJ, Savage J. Azithromycin for the treatment of donovanosis. Sex Transm Infect. Feb 1998;74(1):78-9. [Medline].

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

  10. Centers for Disease Control and Prevention. Sexually transmitted diseases treatment guidelines 2002. Centers for Disease Control and Prevention. MMWR Recomm Rep. May 10 2002;51:1-78. [Medline].

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

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

  13. [Guideline] Centers for Disease Control and Prevention. Diseases characterized by genital ulcers. Sexually transmitted diseases treatment guidelines 2006. MMWR Morb Mortal Wkly Rep. Aug 4 2006;55(RR-11):14-30.

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

  15. 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].

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

  17. Sardana K, Garg VK, Arora P, Khurana N. Malignant transformation of donovanosis (granuloma inguinale) in a HIV-positive patient. Dermatol Online J. Sep 15 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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