Efficacy of ceftriaxone and doxycycline in the treatment of early syphilis.

INTRODUCTION

An increase of syphilis cases has been recorded in the past few decades, especially among HIV-infected patients. These patients often present with concomitant primary and secondary lesions or extensive presentations of syphilis.

OBJECTIVE

Our goal was to compare alternative regimens to the recommended penicillin treatment.

METHOD: We retrospectively studied 116 patient files (80% HIV1-infected) treated for a first episode of early syphilis.

RESULTS

Patients mainly presented with symptoms of secondary syphilis. In 15.5% of the cases patients were asymptomatic and 17.2% of patients with secondary syphilis presented with neurologic or ophthalmic symptoms. Some less usual clinical presentations included diffuse polyadenopathy or isolated fever. The time to serological response was similar among those treated with benzathine-penicillin (n=52), ceftriaxone (n=49), or doxycycline (n=15).

CONCLUSION

Ceftriaxone and doxycycline could be suitable alternatives to penicillin in the treatment of early syphilis in HIV-infected patients. These two treatments have a concomitant effectiveness even for asymptomatic forms of neurosyphilis.