Empirical Therapy for the Management of Acute Proctitis in Homosexual Men

Anne M. Rompalo, Pacita Roberts, Kenneth Johnson, Walter E. Stamm

Research output: Contribution to journalArticlepeer-review

Abstract

An effective empirical treatment regimen would provide a more rapid and less expensive approach to the management of homosexual men with acute proctitis. We conducted a randomized trial in 129 homosexual men who presented with acute proctitis, comparing treatment with an empirical regimen (4.8 million U of aqueous penicillin G procaine intramuscularly and 1.0 g of probenecid orally, followed by 100 mg of oral doxycycline twice daily for seven days) with specific therapy for each infection as it was recognized. Therapy with the empirical regimen resulted in more rapid resolution of the symptoms of proctitis, the objective signs of proctitis, and the infecting microorganisms. However, nearly one fourth of the patients, primarily those with unrecognized herpes simplex virus proctitis, did not respond to empirical therapy. We recommend empirical therapy coupled with appropriate pretreatment diagnostic testing for the initial management of acute proctitis in homosexual men with no clinical evidence of acquired immunodeficiency syndrome or AIDS-related complex.

Original languageEnglish (US)
Pages (from-to)348-353
Number of pages6
JournalJAMA: The Journal of the American Medical Association
Volume260
Issue number3
DOIs
StatePublished - Jul 15 1988
Externally publishedYes

ASJC Scopus subject areas

  • Medicine(all)

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