Background: Lymphogranuloma venereum (LGV) is an ulcerative and invasive sexually transmitted disease (STD) caused by Chlamydia trachomatis Serovar L1, L2, or L3. LGV has become hyperendemic among men who have sex with men (MSM) in Western Europe. Doxycycline (100 mg orally twice daily for 3 weeks, Dox LGV) has long been the regimen of choice because there are no controlled trials supporting alternative treatments. Even though azithromycin (1 g orally once weekly for 3 weeks, prolonged azithromycin regimen, PAz R) is likely to be effective against LGV, limited data are available on the clinical effectiveness of this antibiotic in the treatment of LGV. We aimed to evaluate treatment with oral PAz R in patients presenting with rectal LGV infection. Methods: A longitudinal prospective study at the STD Unit in the Hospital Clinic was conducted in Barcelona between 6/2010 and 4/2014. 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