Abstract
Chancroid is gaining importance as a sexually transmitted disease because of its association with transmission of human immunodeficiency virus type 1 (HIV-1). Effective, simply administered therapy for chancroid is necessary. Fleroxacin is effective against Haemophilus ducreyi in vitro. We performed an initial randomized clinical trial to assess the efficacy of fleroxacin for treatment of chancroid in Nairobi, Kenya. Fifty-three men with culture-positive chancroid were randomly assigned to receive either 200 mg (group 1) or 400 mg (group 2) of fleroxacin as a single oral dose. Groups 1 and 2 were similar with regard to severity of disease, bubo formation, and HIV-1 status. A satisfactory clinical response to therapy was noted in 23 of 26 patients (88%) in group 1 and 18 of 23 patients (78%) in group 2. Bacteriological failure occurred in 1 of 26 evaluable patients (4%) in group 1 and 4 of 23 evaluable patients (17%) in group 2. Two of 37 HIV-1-seronegative men (5%) and 3 of 11 HIV-1-infected men (27%) were bacteriological failures. Fleroxacin, 200 or 400 mg as a single oral dose, is efficacious therapy for microbiologically proven chancroid in patients who do not have concurrent HIV-1 infection. Among HIV-1-infected men, a single dose of 200 or 400 mg of fleroxacin is inadequate therapy for chancroid.
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- Anderson B., Albritton W. L., Biddle J., Johnson S. R. Common beta-lactamase-specifying plasmid in Haemophilus ducreyi and Neisseria gonorrhoeae. Antimicrob Agents Chemother. 1984 Feb;25(2):296–297. doi: 10.1128/aac.25.2.296. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Blackmore C. A., Limpakarnjanarat K., Rigau-Pérez J. G., Albritton W. L., Greenwood J. R. An outbreak of chancroid in Orange County, California: descriptive epidemiology and disease-control measures. J Infect Dis. 1985 May;151(5):840–844. doi: 10.1093/infdis/151.5.840. [DOI] [PubMed] [Google Scholar]
- Dylewski J., Nsanze H., D'Costa L., Slaney L., Ronald A. Trimethoprim sulphamoxole in the treatment of chancroid. Comparison of two single dose treatment regimens with a five day regimen. J Antimicrob Chemother. 1985 Jul;16(1):103–109. doi: 10.1093/jac/16.1.103. [DOI] [PubMed] [Google Scholar]
- Greenblatt R. M., Lukehart S. A., Plummer F. A., Quinn T. C., Critchlow C. W., Ashley R. L., D'Costa L. J., Ndinya-Achola J. O., Corey L., Ronald A. R. Genital ulceration as a risk factor for human immunodeficiency virus infection. AIDS. 1988 Feb;2(1):47–50. doi: 10.1097/00002030-198802000-00008. [DOI] [PubMed] [Google Scholar]
- Haase D. A., Ndinya-Achola J. O., Nash R. A., D'Costa L. J., Hazlett D., Lubwama S., Nsanze H., Ronald A. R. Clinical evaluation of rosoxacin for the treatment of chancroid. Antimicrob Agents Chemother. 1986 Jul;30(1):39–41. doi: 10.1128/aac.30.1.39. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Le Saux N. M., Slaney L. A., Plummer F. A., Ronald A. R., Brunham R. C. In vitro activity of ceftriaxone, cefetamet (Ro 15-8074), ceftetrame (Ro 19-5247; T-2588), and fleroxacin (Ro 23-6240; AM-833) versus Neisseria gonorrhoeae and Haemophilus ducreyi. Antimicrob Agents Chemother. 1987 Jul;31(7):1153–1154. doi: 10.1128/aac.31.7.1153. [DOI] [PMC free article] [PubMed] [Google Scholar]
- McNicol P. J., Ronald A. R. The plasmids of Haemophilus ducreyi. J Antimicrob Chemother. 1984 Dec;14(6):561–564. [PubMed] [Google Scholar]
- Naamara W., Kunimoto D. Y., D'Costa L. J., Ndinya-Achola J. O., Nsanze H., Ronald A. R., Plummer F. A. Treating chancroid with enoxacin. Genitourin Med. 1988 Jun;64(3):189–192. doi: 10.1136/sti.64.3.189. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Naamara W., Plummer F. A., Greenblatt R. M., D'Costa L. J., Ndinya-Achola J. O., Ronald A. R. Treatment of chancroid with ciprofloxacin. A prospective, randomized clinical trial. Am J Med. 1987 Apr 27;82(4A):317–320. [PubMed] [Google Scholar]
- Plummer F. A., Nsanze H., D'Costa L. J., Karasira P., Maclean I. W., Ellison R. H., Ronald A. R. Single-dose therapy of chancroid with trimethoprim-sulfametrole. N Engl J Med. 1983 Jul 14;309(2):67–71. doi: 10.1056/NEJM198307143090202. [DOI] [PubMed] [Google Scholar]
- Schmid G. P., Sanders L. L., Jr, Blount J. H., Alexander E. R. Chancroid in the United States. Reestablishment of an old disease. JAMA. 1987 Dec 11;258(22):3265–3268. [PubMed] [Google Scholar]
- Simonsen J. N., Cameron D. W., Gakinya M. N., Ndinya-Achola J. O., D'Costa L. J., Karasira P., Cheang M., Ronald A. R., Piot P., Plummer F. A. Human immunodeficiency virus infection among men with sexually transmitted diseases. Experience from a center in Africa. N Engl J Med. 1988 Aug 4;319(5):274–278. doi: 10.1056/NEJM198808043190504. [DOI] [PubMed] [Google Scholar]
- Taylor D. N., Pitarangsi C., Echeverria P., Panikabutra K., Suvongse C. Comparative study of ceftriaxone and trimethoprim-sulfamethoxazole for the treatment of chancroid in Thailand. J Infect Dis. 1985 Nov;152(5):1002–1006. doi: 10.1093/infdis/152.5.1002. [DOI] [PubMed] [Google Scholar]
- Weidekamm E., Portmann R., Suter K., Partos C., Dell D., Lücker P. W. Single- and multiple-dose pharmacokinetics of fleroxacin, a trifluorinated quinolone, in humans. Antimicrob Agents Chemother. 1987 Dec;31(12):1909–1914. doi: 10.1128/aac.31.12.1909. [DOI] [PMC free article] [PubMed] [Google Scholar]