Azithromycin compared with penicillin G benzathine for treatment of incubating syphilis.
Author(s): Hook EW 3rd, Stephens J, Ennis DM
Affiliation(s): Department of Medicine, University of Alabama at Birmingham School of Medicine, 35294-0006, USA.
Publication date & source: 1999-09-21, Ann Intern Med., 131(6):434-7.
Publication type: Clinical Trial; Randomized Controlled Trial
BACKGROUND: Preventive therapy is an important element of syphilis control efforts. No currently recommended, single-dose alternatives to penicillin G benzathine are available for treatment of incubating syphilis. OBJECTIVE: To evaluate the use of a single 1.0-g dose of azithromycin for treatment of persons recently exposed to sexual partners with infectious syphilis. DESIGN: Single-center, open-label, randomized pilot study to compare azithromycin with penicillin G benzathine therapy. Participants were evaluated serologically for 3 months. SETTING: Sexually transmitted disease clinic in Birmingham, Alabama. PARTICIPANTS: 96 participants who in the preceding 30 days had been exposed to partners with infectious syphilis through sexual intercourse. MEASUREMENTS: Syphilis prevention, as indicated by nonreactive serologic tests (rapid plasma reagin and fluorescent treponemal antibody-absorbed), throughout the 3-month follow-up. RESULTS: Among 96 participants enrolled, none of 40 evaluable persons in the azithromycin group and none of 23 evaluable persons in the penicillin group developed evidence of syphilis. Significantly more penicillin-treated participants (21 of 44 [48%]) than azithromycin-treated participants (12 of 52 [23%]) became nonevaluable during follow-up (P = 0.01). CONCLUSION: A single 1.0-g dose of azithromycin seems to be efficacious for prevention of syphilis in persons exposed to infected sexual partners.
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