Ceftriaxone Therapy for Syphilis: Report from the Emerging Infections Network
Abstract
Alternatives to penicillin for the treatment of syphilis continue to be sought [1]. The Centers for Disease Control and Prevention (CDC) currently recommend that tetracyclines be used when penicillin injections are contraindicated [2]. Highdose amoxicillin [3] and azithromycin [4] have both been recently studied. The third-generation cephalosporin ceftriaxone is active in vitro against Treponema pallidum [5]. Small-scale studies of patients with syphilis have suggested that this agent has clinical efficacy [6–8]. However, there is currently no generally accepted or recommended dose or dosing schedule for this use of ceftriaxone. During a review of literature on syphilis treatment for the 1998 revision of the CDC Sexually Transmitted Diseases Treatment Guidelines, questions were raised regarding the frequency of ceftriaxone use for the treatment of syphilis in the United States. To address this issue, we enlisted the use of the Infectious Diseases Society of America Emerging Infections Network (EIN), a cooperative agreement program funded by the CDC. In May 1998, the EIN queried 444 infectious diseases consultants who care for adult patients about their use of ceftriaxone for the treatment of patients with early syphilis. Respondents included EIN members from all parts of the continental United States.
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Several different ceftriaxone regimens have been shown to be effective for the treatment of early syphilis.
“Several different ceftriaxone regimens have been shown to be effective for the treatment of early syphilis.104–113”
From BASHH UK guidelines for the management of syphilis 2024 (2024) · cites this paper as [111]
The report (pp. 1337–38) describes several ceftriaxone doses and schedules used for early-stage syphilis and says small studies suggested clinical efficacy. It does not establish that each regimen was effective; it reports therapeutic failures and says there was no generally accepted dose or schedule. (LLM, conf=0.86)
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Cites
Dowell, M. E., Ross, P. G., Musher, D. M., Cate, T. R., & Baughn, R. E. (1992) · The American Journal of Medicine · doi:10.1016/0002-9343(92)90574-u · Cited by 133 · see citing works
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Smith, N. H., Musher, D. M., Huang, D. B., Rodriguez, P. S., Dowell, M. E., Ace, W., & White, A. C. (2004) · International Journal of STD & AIDS · doi:10.1177/095646240401500511 · Cited by 74 · see citing works
BASHH UK guidelines for the management of syphilis 2024
Kingston, M., Apea, V., Evans, C., Fifer, H., Foster, K., Patrick, P., Grant, A., Manns, V., Ramsden, S., Sinka, K., et al. (2024) · International Journal of STD & AIDS · doi:10.1177/09564624241280406 · Cited by 51 · see citing works
- Authors
- Augenbraun, M., & Workowski, K.
- Affiliations
- SUNY Downstate Health Sciences University (US)
- Centers for Disease Control and Prevention (US)
- Corresponding author
- Augenbraun, M.
- Venue
- Clinical Infectious Diseases
- Publisher
- Oxford University Press (OUP)
- Published
- 1999-11-01
- Volume
- 29
- Issue
- 5
- Pages
- 1337-1338
- ISSN
- 1058-4838 (ISSN-L)
- 1537-6591
- OpenAlex
- W2026247762
- Cited by
- 32
- References
- 1
- Citations by year
- 2024: 1 · 2023: 1 · 2021: 2 · 2019: 1 · 2015: 3 · 2014: 2 · 2012: 1
- FWCI
- 0.76
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Clinical Infectious Diseases (publishedVersion)
- PubMed (publishedVersion)
- Funders
- U.S. Public Health Service (U50/CCU112346)
- Topics
- Health Sciences › Medicine › Physiology › Syphilis Diagnosis and Treatment
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Historical Medical Research and Treatments
- Health Sciences › Medicine › Pharmacology › Antibiotics Pharmacokinetics and Efficacy
- Keywords
- ceftriaxone, syphilis, Treponema pallidum, early syphilis, third-generation cephalosporins, antibiotic dosing, CDC treatment guidelines, clinician survey, sexually transmitted infections
- MeSH terms
- Ceftriaxone, Cephalosporins, Humans, Syphilis
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