title: Enhanced therapy for primary and secondary syphilis: a longitudinal retrospective analysis of cure rates and associated factors.
abstract: For the treatment of early infectious syphilis, enhanced therapy with three dosages of benzathine penicillin G has been under consideration, particularly in the human immunodeficiency virus type 1 infected population (HIV-1). The serological outcome of 249 patients with primary and secondary syphilis treated with standard or enhanced therapy was analyzed retrospectively; 98% (139/142) achieved serological cure with a single dosage and 92% with enhanced therapy (P=0.033). In HIV-1 infected individuals, cure rates were 88% after a single dosage compared to 97% after three dosages (P=0.18). A fourfold decrease of Venereal Disease Research Laboratory (VDRL) titres was achieved within a median of 102 days after treatment initiation (SD=2; 95% CI=98-106). Patients aged over 40 years were 5.5 times (OR=5.52; 95% CI=1.43-21.32; P=0.013) and patients with low baseline VDRL titres (≤ 1:32) were 4 times (OR=4.25; 95% CI=1.21-14.87; P=0.024) more likely to experience serological failure.
authors.affiliation: Department of Dermatology, Division of Immunology, Allergy and Infectious Diseases (DIAID), Medical University of Vienna, Vienna, Austria.
authors.forename: Julia
authors.initials: J
authors.lastname: Tittes
authors.forename: Maximilian C
authors.initials: MC
authors.lastname: Aichelburg
authors.forename: Lukasz
authors.initials: L
authors.lastname: Antoniewicz
authors.forename: Alexandra
authors.initials: A
authors.lastname: Geusau
mesh_terms: D000328:Adult; D017677:Age Distribution; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D018023:HIV Seronegativity; D006679:HIV Seropositivity / Q000150:complications; D015497:HIV-1 / Q000276:immunology; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D010401:Penicillin G Benzathine / Q000627:therapeutic use*; D012189:Retrospective Studies; D013587:Syphilis / Q000150:complications / Q000188:drug therapy*; D013588:Syphilis Serodiagnosis; D016896:Treatment Outcome; D014210:Treponema pallidum / Q000302:isolation & purification*
chemical_list: D000900:Anti-Bacterial Agents; D010401:Penicillin G Benzathine
keywords: Europe; HIV; Syphilis (Treponema pallidum); Veneral Disease Research laboratory (VDRL) test; antibiotic; bacterial disease; benzathine penicillin G; serology; sexually transmitted infections; titre; treatment