The Centers for Disease Control and Prevention (CDC) recommends azithromycin 1 g weekly for at least 3 weeks or until all lesions have healed. Azithromycin should be effective in most HIV positive subjects with significant immune impairment.
Other antibiotics that may be effective if given for 3 weeks or until ulcers have healed fully include: co-trimoxazole, ciprofloxacin, doxycycline, gentamicin intramuscularly or intravenously.
Erythromycin 500 mg four times daily for at least 3 weeks is used for pregnant patients.
Recurrence may occur despite good initial responses.