Yaws Treatment & Management

Updated: Oct 25, 2021
  • Author: Hassan I Galadari, MD; Chief Editor: William D James, MD  more...
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Approach Considerations

Penicillin is the drug of choice for yaws. After a single penicillin injection, early lesions become noninfectious after 24 hours and heal within 1-2 weeks. Tetracycline, erythromycin, or doxycycline should be considered for patients allergic to penicillin. [19]

In one study in children in Papua New Guinea, oral azithromycin was found to be a reasonable alternative for treating yaws; in addition, it is a simpler regimen that does not require trained medical personnel for administration. In this study, children aged 6 months to 15 years who were diagnosed with yaws were randomly assigned to receive either one 30 mg/kg oral dose of azithromycin or an intramuscular (IM) injection of 50,000 units/kg of benzathine benzylpenicillin. After 6 months of follow-up, 96% of patients in the azithromycin group were cured, compared with 93% in the benzathine benzylpenicillin group. [10]

A new yaws eradication program was proposed in 2012 as the result of the azithromycin study conducted in Papua New Guinea. [10] The World Health Organization (WHO) has concluded that this new eradication campaign can completely eliminate yaws worldwide by 2020. [8]

Epidemiologic treatment recommendations for yaws are as follows:

  • If greater than 50% of children are seropositive (hyperendemic), treat the entire population

  • If 10-50% of children are seropositive (mesoendemic), treat active cases, contacts, and all children aged 15 years or younger

  • If less than 10 of children are seropositive (hypoendemic), treat active cases, household members, and other obvious contacts