Clinical management of early syphilis

Abstract

Early syphilis therapy was a focus of intense research in the early 20th century with many and varied approaches being used. The development of penicillin and its efficacy in the treatment of syphilis transformed syphilis management for many with and at risk for infection. However, problems such as beta-lactam allergies and the desire for easily administered, alternate therapies have led to evaluation of multiple other drugs, with doxycycline currently recommended as the main alternative. Ceftriaxone and azithromycin have been shown to be effective, however, each has its own difficulties. Follow-up relies on serological testing, leading to concerns when these tests do not decline appropriately. Given concerns about the potential for increased risk for treatment failure, patients with HIV and pregnant women are of particular concern.

Public health interventions to control syphilis

“…91 Treatment failures and reports of Increasing resistance now limit the prospects for mass treatment using azithromycin. 92 However, many MSM in Australia have reported they would be willing to take doxycycline to prevent syphilis. 93…”

Association of TNF‐α 308 G > A gene polymorphism with serofast in patients with syphilis

“…Their onset is variable, usually appearing during the first two months of treatment. 6 The objective of our study was to characterise the drug-related AEs, their grade of severity and their timing of onset. This study was conducted at one referral centre for skin cancer diagnosis and management.…”

Clinical Evidence for Individual Animal Therapy for Papillomatous Digital Dermatitis (Hairy Heel Wart) and Infectious Bovine Pododermatitis (Foot Rot)

“…With issues of treatment due to penicillin G allergies, the antimicrobials tetracycline, doxycycline, erythromycin, azithromycin, and ceftriaxone have been evaluated and used for therapy. 30 However, macrolide resistance was reported in Irish and US isolates of T pallidum in 2004 and linked to a mutation in the 23S ribosomal RNA genes. 31 This resistance is now appearing in multiple locations around the world.…”