title: A new enhanced antibiotic treatment for early and late syphilis.
abstract: The objective of this study was to evaluate the efficacy of an enhanced treatment regimen for syphilis with the addition of doxycycline and ceftriaxone to the conventional benzathine penicillin G (BPG) treatment. Sixty-nine syphilis patients were recruited and were randomly assigned to two groups: group 1 (38 patients) received standard therapy and group 2 (31 patients) received the enhanced therapy. All patients were followed-up for at least 12 months. Patients underwent physical examination and serology every 6 months as well as echocardiography and neurological examination every year. A three- to four-fold decline in the initial Venereal Disease Research Laboratory (VDRL) titre within 6 months after therapy was considered as serological cure. At 12 months, 68% of patients in group 1 and 100% in group 2 were serologically cured (P=0.002). During follow-up, no patients in group 2 experienced complications related to syphilis. In contrast, one patient in group 1 developed neurosyphilis. In conclusion, the enhanced treatment is more effective than standard treatment and results in a higher and faster cure rate. Moreover, it provides treponemicidal antibiotic levels in the cerebrospinal fluid, thereby preventing possible late complications.
authors.affiliation: DISSAL, Department of Dermatology, IRCCS A.O.U. San Martino-IST, Largo R. Benzi 10, 16132 Genoa, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Drago
authors.affiliation: DISSAL, Department of Dermatology, IRCCS A.O.U. San Martino-IST, Largo R. Benzi 10, 16132 Genoa, Italy. Electronic address: giuliaciccarese@libero.it.
authors.forename: Giulia
authors.initials: G
authors.lastname: Ciccarese
authors.affiliation: Department of Health Sciences, University of Milano-Bicocca, 20900 Monza, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Broccolo
authors.affiliation: DISSAL, Department of Dermatology, IRCCS A.O.U. San Martino-IST, Largo R. Benzi 10, 16132 Genoa, Italy.
authors.forename: Giulia
authors.initials: G
authors.lastname: Sartoris
authors.affiliation: Regional Blood Service - Liguria Region, IRCCS A.O.U. San Martino-IST, Largo R. Benzi 10, 16132 Genoa, Italy.
authors.forename: Paola
authors.initials: P
authors.lastname: Stura
authors.affiliation: Pediatric Highly Intensive Care Unit, Department of Pathophysiology and Transplantation, Università Degli Studi di Milano, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
authors.forename: Susanna
authors.initials: S
authors.lastname: Esposito
authors.affiliation: DISSAL, Department of Dermatology, IRCCS A.O.U. San Martino-IST, Largo R. Benzi 10, 16132 Genoa, Italy.
authors.forename: Alfredo
authors.initials: A
authors.lastname: Rebora
authors.affiliation: DISSAL, Department of Dermatology, IRCCS A.O.U. San Martino-IST, Largo R. Benzi 10, 16132 Genoa, Italy.
authors.forename: Aurora
authors.initials: A
authors.lastname: Parodi
mesh_terms: D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002443:Ceftriaxone / Q000627:therapeutic use*; D004318:Doxycycline / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010401:Penicillin G Benzathine / Q000627:therapeutic use*; D013587:Syphilis / Q000188:drug therapy*; D013588:Syphilis Serodiagnosis; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D002443:Ceftriaxone; D004318:Doxycycline; D010401:Penicillin G Benzathine
keywords: Benzathine penicillin G; Ceftriaxone; Doxycycline; Syphilis