Single-Dose Azithromycin versus Penicillin G Benzathine for the Treatment of Early Syphilis

Riedner, Gabriele; Rusizoka, Mary; Todd, Jim; Maboko, Leonard; Höelscher, Michael; Mmbando, Donan; Samky, Eleuter; Lyamuya, Eligius; Mabey, David; Grosskurth, Heiner; Hayes, Richard

doi:10.1056/nejmoa044284

Cited by 266 publications

(171 citation statements)

References 12 publications

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“…59 Despite concerns about drug resistance, 60 a 2-g dose of azithromycin has resulted in cure rates of 97.7% (95% CI, 94.0%-99.4%) of syphilis cases in a study in Tanzania. 61 A single 2-g dose of azithromycin was 98.9% (95% CI, 97.9%-100%) efficacious against N gonorrhoeae in the United States, 62 while meta-analysis showed that 1 g cures 96.5% (95% CI, 95.3%-97.7%) of C trachomatis infections. 63 A trial in Malawi using 1 g of azithromycinadministeredtwicewithSPIPTp reduced the risk of T vaginalis 35% (P=.02).…”

Section: Commentmentioning

confidence: 99%

Prevalence of Malaria and Sexually Transmitted and Reproductive Tract Infections in Pregnancy in Sub-Saharan Africa

Chico¹,

Mayaud²,

Ariti³

et al. 2012

JAMA

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173

129

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Section: Commentmentioning

confidence: 99%

Prevalence of Malaria and Sexually Transmitted and Reproductive Tract Infections in Pregnancy in Sub-Saharan Africa

Chico¹,

Mayaud²,

Ariti³

et al. 2012

JAMA

Self Cite

173

129

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“…19 Oral doxycycline is an alternative in those who are penicillin allergic, intolerant of injections or non-pregnant. Azithromycin has shown to be at least as effective in producing serological cure as penicillin, 20 but initial enthusiasm has waned with the demonstration of high levels of azithromycin resistance in regions where macrolide use is high. In Sydney, the prevalence of the azithromycin resistance gene A2058G on the 23 s ribosome of T. pallidum was present in over 85% of samples.…”

Section: Treatment Of Syphilismentioning

confidence: 99%

Clinical aspects of adult syphilis

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Donovan

2012

Internal Medicine Journal

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Syphilis has been resurgent in Australian cities for the last decade. The varied presentation of this infection requires the physician to consider syphilis in the differential diagnosis of a broad range of conditions. Most cases are in men who have sex with men, young people in remote Aboriginal communities, or travellers from high‐prevalence countries. The diagnosis and staging of syphilis require a sexual history, physical examination and interpretation of serological and microbiological findings. Penicillin remains the mainstay of effective treatment and has been used successfully for over 65 years. Treatment failure is rare, whereas reinfection is common. The interaction of syphilis and human immunodeficiency virus is complex, but standard therapy remains curative, and lumbar puncture is rarely required. Regular testing of high‐risk individuals, contact tracing with empirical treatment and serological follow up are important components of syphilis control.

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“…12 A recent large, prospective randomised trial suggested single-dose azithromycin is as effective in treating early syphilis as benzathine penicillin. 13 However, there are concerns regarding azithromycin treatment failure which appears to be due to intrinsic macrolide resistance in some strains of T. pallidum. A number of ceftriaxone regimens were effective in small studies.…”

Section: Neurosyphilismentioning

confidence: 99%