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Cited by 79Syphilis Diagnosis and TreatmentHistorical Medical Research and TreatmentsVector-borne infectious diseases

Primary syphilis: serological treatment response to doxycycline/tetracycline versus benzathine penicillin.

Wong, Tom, Singh, Ameeta E., De, Prithwish·2008·The American Journal of Medicine
DOI 10.1016/j.amjmed.2008.04.042
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Abstract

Background Benzathine penicillin G is the treatment of choice for infectious syphilis, but tetracycline and doxycycline are believed to be effective second-line treatments. The objective of this study was to assess the serological response from treatment of primary syphilis with benzathine penicillin compared with doxycycline or tetracycline.Methods We examined rapid plasma reagin serological test results of all first-time primary syphilis patients in Alberta, Canada from 1980 to 2001 and compared treatment with single dose of penicillin with 14-day course of oral doxycycline (100 mg twice a day) or oral tetracycline (500 mg 4 times a day). Serological treatment success was defined as a minimum 4-fold decrease in baseline rapid plasma reagin test antibody titer within 6 months, or > or =8-fold decrease within 12 months, or > or =16-fold decrease by 24 months. The median time to successful response was estimated, and factors associated with treatment success were identified by unadjusted logistic regression.Results Of the 445 primary syphilis cases with available treatment outcome data, 420 (94.4%) received penicillin and 25 (5.6%) received doxycycline/tetracycline. The serological treatment success rate was 97.4% in the penicillin group (409/420) and 100% in the doxycycline/tetracycline group (25/25), and not significantly different. The estimated median time to serological treatment success was 72.0 days (mean=101.7, range 10-603) in penicillin and 43.0 days (mean=78.6, range 15-334) in doxycycline/tetracycline-treated patients; however, this difference was not statistically significant (P=0.16).Conclusion Doxycycline/tetracycline had a similarly high serological treatment success rate when compared with penicillin in the treatment of primary syphilis.

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  • Doxycycline (100 mg orally 2 times/day for 14 days) can be effective for nonpregnant persons with penicillin allergy who have primary or secondary syphilis.

    “Doxycycline (100 mg orally 2 times/day for 14 days) (600,601) and tetracycline (500 mg orally 4 times/day for 14 days) have been used for years and can be effective.”

    From Sexually Transmitted Infections Treatment Guidelines, 2021 (2021) · cites this paper as [601]

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Authors
Wong, T., Singh, A. E., & De, P.
Affiliations
  • Public Health Agency of Canada (CA)
  • University of Alberta (CA)
  • McGill University (CA)
Corresponding author
Singh, Ameeta E.
ORCID
Venue
The American Journal of Medicine
Publisher
Elsevier BV
Published
2008-10
Volume
121
Issue
10
Pages
903-908
ISSN
0002-9343 (ISSN-L)
DOI
10.1016/j.amjmed.2008.04.042
OpenAlex
W2043574317
Cited by
79
References
24
Citations by year
2025: 6 · 2024: 4 · 2023: 4 · 2022: 3 · 2021: 6 · 2020: 8 · 2019: 1 · 2018: 4 · 2017: 4 · 2016: 3 · 2015: 8 · 2014: 8 · 2013: 5 · 2012: 2
FWCI
2.49
Type
journal article
Language
en
Open access
closed
Licence
Locations
  • The American Journal of Medicine (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Physiology › Syphilis Diagnosis and Treatment
  • Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Historical Medical Research and Treatments
  • Life Sciences › Immunology and Microbiology › Parasitology › Vector-borne infectious diseases
Keywords
primary syphilis, doxycycline, tetracycline, benzathine penicillin, treatment success rate, treatment response time
MeSH terms
Adolescent, Adult, Anti-Bacterial Agents, Doxycycline, Female, Humans, Male, Penicillin G Benzathine, Retrospective Studies, Serologic Tests, Syphilis, Cohort Studies

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