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:::*Note:Management of intra-anal warts should include consultation with a specialist.  
:::*Note:Management of intra-anal warts should include consultation with a specialist.  


Granuloma Inguinale (Donovanosis)
 
 
:*'''Granuloma Inguinale (Donovanosis)'''
:::*Preferred regimen:[[Azithromycin]] 1 g PO once per week {{or}} 500 mg  PO qd  for  3 weeks and until all lesions have completely healed
:::*Preferred regimen:[[Azithromycin]] 1 g PO once per week {{or}} 500 mg  PO qd  for  3 weeks and until all lesions have completely healed
:::*Alternative Regimen:[[Doxycycline]] 100 mg PO bid for 3 weeks  {{or}}[[Ciprofloxacin]] 750 mg PO bid for 3 weeks  {{or}}
:::*Alternative Regimen:[[Doxycycline]] 100 mg PO bid for 3 weeks  {{or}}[[Ciprofloxacin]] 750 mg PO bid for 3 weeks  {{or}}[[Erythromycin]] base 500 mg PO qid for 3 weeks {{or}} [[Trimethoprim-sulfamethoxazole]] one double-strength (160 mg/800 mg) PO bid for 3 weeks
[[Erythromycin]] base 500 mg PO qid for 3 weeks {{or}} [[Trimethoprim-sulfamethoxazole]] one double-strength (160 mg/800 mg) PO bid for 3 weeks


Pregnant and lactating women
:*'''Pregnant and lactating women'''
:::*Preferred regimen:treated with a macrolide regimen (erythromycin or azithromycin). The addition of an aminoglycoside (gentamicin 1 mg/kg IV every 8 hours) can be considered if improvement is not evident within the first few days of therapy.
:::*Preferred regimen:treated with a macrolide regimen (erythromycin or azithromycin). The addition of an aminoglycoside (gentamicin 1 mg/kg IV every 8 hours) can be considered if improvement is not evident within the first few days of therapy.


HIV Infection
:*'''HIV Infection'''
:::*Preferred regimen:[[Azithromycin]] 1 g PO once per week {{or}} 500 mg  PO qd  for  3 weeks and until all lesions have completely healed
:::*Preferred regimen:[[Azithromycin]] 1 g PO once per week {{or}} 500 mg  PO qd  for  3 weeks and until all lesions have completely healed
:::*Alternative Regimen:[[Doxycycline]] 100 mg PO bid for 3 weeks  {{or}}[[Ciprofloxacin]] 750 mg PO bid for 3 weeks  {{or}}
:::*Alternative Regimen:[[Doxycycline]] 100 mg PO bid for 3 weeks  {{or}}[[Ciprofloxacin]] 750 mg PO bid for 3 weeks  {{or}} [[Erythromycin]] base 500 mg PO qid for 3 weeks {{or}} [[Trimethoprim-sulfamethoxazole]] one double-strength (160 mg/800 mg) PO bid for 3 weeks  
[[Erythromycin]] base 500 mg PO qid for 3 weeks {{or}} [[Trimethoprim-sulfamethoxazole]] one double-strength (160 mg/800 mg) PO bid for 3 weeks  
:::*Note:The addition of an aminoglycoside (gentamicin 1 mg/kg IV every 8 hours) can be considered if improvement is not evident within the first few days of therapy.
:::*Note:The addition of an aminoglycoside (gentamicin 1 mg/kg IV every 8 hours) can be considered if improvement is not evident within the first few days of therapy.

Revision as of 16:54, 2 July 2015


  • 1.Preferred regimen for External Anogenital Warts (i.e., penis, groin, scrotum, vulva, perineum, external anus, and perianus)
  • 1.1 Patient-Applied::Imiquimod 3.75% or 5% cream ORPodofilox 0.5% solution or gel OR Sinecatechins 15% ointment
  • 1.2 Provider-Administered:Cryotherapy with liquid nitrogen or cryoprobe OR Surgical removal either by tangential scissor excision, tangential shave excision, curettage, laser,or electrosurgery OR Trichloroacetic acid (TCA) or Bichloroacetic acid (BCA) 80%-90% solution
  • Note(1):Many persons with external anal warts also have intra-anal warts. Thus, persons with external anal warts might benefit from an inspection of the anal canal by digital examination, standard anoscopy, or high-resolution anoscopy.
  • Note(2):Might weaken condoms and vaginal diaphragms.
  • 2.Alternative Regimens for External Genital Warts
  • 2.1 Urethral Meatus Warts
  • Regimens :Cryotherapy with liquid nitrogen OR Surgical removal
  • 2.2 Vaginal Warts
  • Regimens:Cryotherapy with liquid nitrogen. OR Surgical removal OR TCA or BCA 80%–90% solution
  • Note: The use of a cryoprobe in the vagina is not recommended because of the risk for vaginal perforation and fistula formation
  • 2.3 Cervical Warts
  • Regimen: Cryotherapy with liquid nitrogen OR Surgical removal OR TCA or BCA 80%–90% solution
  • Note: Management of cervical warts should include consultation with a specialist.For women who have exophytic cervical warts, a biopsy evaluation to exclude high-grade SIL must be performed before treatment is initiated.
  • 2.4 Intra-anal Warts
  • Regimens :Cryotherapy with liquid nitrogen OR Surgical removalOR TCA or BCA 80%–90% solution
  • Note:Management of intra-anal warts should include consultation with a specialist.


  • Granuloma Inguinale (Donovanosis)
  • Pregnant and lactating women
  • Preferred regimen:treated with a macrolide regimen (erythromycin or azithromycin). The addition of an aminoglycoside (gentamicin 1 mg/kg IV every 8 hours) can be considered if improvement is not evident within the first few days of therapy.
  • HIV Infection
  • Preferred regimen:Azithromycin 1 g PO once per week OR 500 mg PO qd for 3 weeks and until all lesions have completely healed
  • Alternative Regimen:Doxycycline 100 mg PO bid for 3 weeks ORCiprofloxacin 750 mg PO bid for 3 weeks OR Erythromycin base 500 mg PO qid for 3 weeks OR Trimethoprim-sulfamethoxazole one double-strength (160 mg/800 mg) PO bid for 3 weeks
  • Note:The addition of an aminoglycoside (gentamicin 1 mg/kg IV every 8 hours) can be considered if improvement is not evident within the first few days of therapy.