Single-Dose Azithromycin versus Penicillin G Benzathine for the Treatment of Early Syphilis

This randomized trial involving patients with early syphilis in Tanzania found that treatment with 2 g of azithromycin led to cure rates that were similar to those for penicillin G benzathine at both nine months (97.7 percent and 95.0 percent, respectively) and six months (85.5 percent and 81.5 perc...

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Veröffentlicht in:The New England journal of medicine Jg. 353; H. 12; S. 1236 - 1244
Hauptverfasser: Riedner, Gabriele, Rusizoka, Mary, Todd, Jim, Maboko, Leonard, Hoelscher, Michael, Mmbando, Donan, Samky, Eleuter, Lyamuya, Eligius, Mabey, David, Grosskurth, Heiner, Hayes, Richard
Format: Journal Article
Sprache:Englisch
Veröffentlicht: Boston, MA Massachusetts Medical Society 22.09.2005
Schlagworte:
Administration, Oral
Adolescent
Adult
Anti-Bacterial Agents - administration & dosage
Anti-Bacterial Agents - therapeutic use
Azithromycin - administration & dosage
Bacterial diseases
Bacterial diseases of the genital system
Biological and medical sciences
Developing Countries
Female
General aspects
HIV
HIV Seropositivity - complications
Human bacterial diseases
Human immunodeficiency virus
Humans
Infections
Infectious diseases
Injections, Intramuscular
Male
Medical sciences
Penicillin
Penicillin G Benzathine - administration & dosage
Penicillin G Benzathine - therapeutic use
Proportional Hazards Models
Syphilis - complications
Syphilis - drug therapy
Treponema pallidum
Ulcers
β-Lactams
Azithromycin
Single dose
Early stage
Macrolide
Treponematosis
Infection
Penicillin derivatives
Medicine
Antibiotic
Sexually transmitted disease
Treatment
Spirochaetosis
Syphilis
Bacteriosis
Antibacterial agent
Benzathine benzylpenicillin
Comparative study
ISSN:0028-4793, 1533-4406, 1533-4406
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Zusammenfassung:This randomized trial involving patients with early syphilis in Tanzania found that treatment with 2 g of azithromycin led to cure rates that were similar to those for penicillin G benzathine at both nine months (97.7 percent and 95.0 percent, respectively) and six months (85.5 percent and 81.5 percent, respectively). This single-dose, oral regimen may be particularly useful in settings in which there are shortages of sterile equipment and trained personnel. In 328 patients with early syphilis in Tanzania, treatment with 2 g of azithromycin led to cure rates that were similar to those for penicillin G benzathine at both nine months and six months. A single intramuscular injection of 2.4 million units (MU) of penicillin G benzathine is the recommended therapy for early syphilis. 1 Major advantages of this regimen are its low cost and absence of problems related to poor adherence, whereas disadvantages include pain associated with large-volume (4 ml), deep, intramuscular injections; the relatively high prevalence of self-reported penicillin allergy in some settings; and the need for injection equipment and medically trained personnel, which may be lacking in countries with few health resources. In addition, there are risks of transmission of blood-borne infections, such as human immunodeficiency virus (HIV), if injection equipment is . . .
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ISSN:0028-4793
1533-4406
1533-4406
DOI:10.1056/NEJMoa044284