Proctitis – Acute
Ceftriaxone 500 mg* IM in a single dose
Doxycycline 100 mg orally 2 times/day for 7 days†
* For persons weighing ≥150 kg, 1 g of ceftriaxone should be administered.
† Doxycycline course should be extended to 100 mg orally 2 times/day for 21 days in the presence of bloody discharge, perianal or mucosal ulcers, or tenesmus and a positive rectal chlamydia test.
Persons with HIV infection and acute proctitis might present with bloody discharge, painful perianal ulcers, or mucosal ulcers and LGV and herpes proctitis are more prevalent among this population. Presumptive treatment in such cases should include a regimen for genital herpes and LGV.