What Is the First-Line Treatment of Lymphogranuloma Venereum?
Lymphogranuloma venereum (LGV) is a sexually transmitted infection requiring prompt, guideline-directed treatment. Appropriate management leads to measurable clinical improvement, particularly in anorectal presentations.
In anorectal disease, the treatment target is symptom resolution — expected within 1–2 weeks of commencing antibiotic therapy. Monitoring for this response helps confirm treatment adequacy.
First-line management centres on a defined course of oral antibiotic therapy. In select presentations, a procedural intervention targeting fluctuant lymph nodes may also form part of management. The complete regimen — including antibiotic class, duration, and the specific procedural guidance — is available in the full protocol.
DOI: 10.1111/jdv.15729
- Doxycycline 100 mg twice a day orally for 21 days (1,B) (Table 1).
- Apart from oral antibiotic therapy, fluctuant buboes should be drained via needle aspiration through healthy overlying skin (2,D).
- In anorectal disease, symptoms should resolve within 1–2 weeks of commencing antibiotic therapy (2,C).