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Penicillin Still Best Drug for Syphilis – CDC

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A recent report that some patients with syphilis in San Francisco did not respond to the antibiotic Zithromax (azithromycin) reinforces current recommendations that penicillin is still the preferred drug for this disease, according to the US Centers for Disease Control and Prevention.

A recent report that some patients with syphilis in San Francisco did not respond to the antibiotic Zithromax (azithromycin) reinforces current recommendations that penicillin is still the preferred drug for this disease, according to the US Centers for Disease Control and Prevention. Syphilis rates have been increasing throughout the US in recent years, CDC investigators point out. A particular problem area has been San Francisco, which had one of the highest rates of primary and secondary syphilis in the country in 2002. In an effort to treat syphilis cases early, certain disease-control programs began administering Zithromax as a single oral pill, a more convenient alternative to a penicillin injection. Support for this approach is based on several small studies that have shown good results in patients without HIV infection. However, in April 2003, the San Francisco Department of Public Health became aware of a syphilis patient who failed treatment with Zithromax. Further investigation uncovered seven other apparent treatment failures that occurred between September 2002 and July 2003. All of the patients were male and self-reported as homosexual, according to an article in the CDC’s in the Morbidity and Mortality Weekly Report. Five patients were infected with HIV. Treatment with penicillin or doxycycline successfully cleared the syphilis infection in all cases. Although penicillin remains the treatment of choice for syphilis, the CDC notes, a “dose of azithromycin may be considered for penicillin-allergic patients, but only with close follow-up because treatment efficacy is not well documented and has not been studied in persons with HIV infection.” SOURCE: Morbidity and Mortality Weekly Report, March 12, 2004.


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Dates

Posted On: 14 March, 2004
Modified On: 5 December, 2013


Created by: myVMC