A Multicenter Study Evaluating Ceftriaxone and Benzathine Penicillin G as Treatment Agents for Early Syphilis in Jiangsu, China.

Abstract

BACKGROUND:

The aim of this study was to assess the efficacy of ceftriaxone and benzathine penicillin G (BPG) in nonpregnant, immunocompetent adults with early syphilis because there is a lack of clinical evidence supporting ceftriaxone as an alternative treatment for early syphilis without an human immunodeficiency virus coinfection.

METHODS:

A randomized, open-label controlled study evaluating the efficacy of ceftriaxone and BPG was conducted in 4 hospitals in Jiangsu Province. Treatment comprised either ceftriaxone (1.0 g, given intravenously, once daily for 10 days) or BPG (2.4 million units, given intramuscularly, once weekly for 2 weeks). A serological response was defined as a ≥4-fold decline in the rapid plasma reagin (RPR) titer.

RESULTS:

In all, 301 patients with early syphilis were enrolled in this study; 230 subjects completed the follow-ups. The serological response at 6 months of follow up was observed in 90.2% in ceftriaxone group and 78.0% in BPG group (P = .01). There was no significant difference between treatment groups in patients with primary or early latent syphilis, but among patients with secondary syphilis the difference was highly significant (95.8% vs 76.2%; P < .01). Moreover, patients exhibiting a Jarisch-Herxheimer reaction after treatment might have a shorter period before a serological response (P = .03).

CONCLUSIONS:

In this study, ceftriaxone regimen was noninferior to the BPG regimen in nonpregnant, immunocompetent patients with early syphilis.

CLINICAL TRIALS REGISTRATION:

ChiCTR-TQR-13003624.

• Authors: Yuping Cao, Xiaohong Su, Qianqiu Wang, Huazhong Xue, Xiaofeng Zhu, Chuanfu Zhang, Juan Jiang, Shuzhen Qi, Xiangdong Gong, Xiaofang Zhu, Min Pan, Hong Ren, Wenlong Hu, Zhiping Wei, Meihua Tian, Weida Liu
• Journal: Clinical infectious diseases : an official publication of the Infectious Diseases Society of America (Clin Infect Dis) Vol. 65 Issue 10 Pg. 1683-1688 (Oct 30 2017) ISSN: 1537-6591 [Electronic] United States
• PMID: 29020150 (Publication Type: Journal Article, Multicenter Study, Randomized Controlled Trial)
• Copyright: © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: [email protected].

Chemical References

• Anti-Bacterial Agents
• Ceftriaxone
• Penicillin G Benzathine

Topics

• Adolescent
• Adult
• Aged
• Anti-Bacterial Agents (therapeutic use)
• Ceftriaxone (therapeutic use)
• China
• Female
• Follow-Up Studies
• Humans
• Male
• Middle Aged
• Penicillin G Benzathine (therapeutic use)
• Syphilis (drug therapy)
• Syphilis Serodiagnosis
• Young Adult