Antimicrobial therapy is the mainstay of treatment for lymphogranuloma venerum. Doxycycline 100 mg PO bid for 21 days is the preferred regimen. Alternative regimens include either erythromycin or azithromycin.

Successful treatment for LGV cures the infection, resolves the clinical symptoms, and prevents transmission to others. All patients need antimicrobial therapy.

• Lymphogranuloma venereum (LGV) treatment^[1]

• Preferred regimen: Doxycycline 100 mg PO bid for 3 weeks
• Alternative regimen: Erythromycin base 500 mg PO qid for 3 weeks
• Note (1): Azithromycin 1 g PO once weekly for 3 weeks is probably effective based on its chlamydial antimicrobial activity. Fluoroquinolone-based treatments might also be effective, but extended treatment intervals are likely required.
• Note (2): Pregnant and lactating women should be treated with Erythromycin. Azithromycin might prove useful for treatment of LGV in pregnancy, but no published data are available regarding its safety and efficacy. Doxycycline is contraindicated in pregnant women but compatible with breastfeeding.
• Note (3): Persons with both LGV and HIV infection should receive the same regimens as those who are HIV negative. Prolonged therapy might be required, and delay in resolution of symptoms might occur.

Patients should be followed clinically until signs and symptoms resolve.^[2]

• Persons who have had sexual contact with a patient who has LGV within the 60 days before onset of the patient’s symptoms should be examined and tested for urethral, cervical, or rectal chlamydial infection depending on anatomic site of exposure
• They should be presumptively treated with a chlamydia regimen (azithromycin 1 g orally single dose or doxycycline 100 mg orally twice a day for 7 days)^[2]

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