A patient presents with a single painful penile ulcer and regional lymphadenopathy; what is the preferred treatment for likely chancroid?

• A. Azithromycin
• B. Doxycycline
• C. Ceftriaxone
• D. Metronidazole

Answer: (A)

Chancroid is an STI caused by Haemophilus ducreyi and typically presents with a painful genital ulcer and tender regional lymphadenopathy, unlike the painless chancre of syphilis. The preferred treatment is a single-dose oral antibiotic because it provides rapid, reliable cure with excellent tissue penetration and is easiest for patients to complete. Azithromycin given as a 1 g single dose fits this well, offering high effectiveness, good tolerability, and minimal impact on adherence. Alternatives exist, such as a single-dose injectable ceftriaxone, but it requires an injection; doxycycline is effective but requires a 7-day course, which can reduce adherence; metronidazole does not cover Haemophilus ducreyi and is not appropriate for chancroid.