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European Journal of Medical Research

Erschienen in:

01.12.2011 | Research

Response of HIV-infected patients with syphilis to therapy with penicillin or intravenous ceftriaxone

verfasst von: P Spornraft-Ragaller, S Abraham, C Lueck, M Meurer

Erschienen in: European Journal of Medical Research | Ausgabe 2/2011

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Abstract

Background

Ceftriaxone is commonly used as an alternative antibiotic drug in treating syphilis but clinical data on its efficacy are limited. Objective: To evaluate the response of HIV-infected patients with active syphilis to treatment with penicillin or ceftriaxone.

Methods

A retrospective study involving 24 consecutive patients with a positive Veneral Disease Research Laboratory test (VDRL) and at least one specific treponemal test. 12 patients were treated with different regimens of high-dose penicillin G for at least 2 weeks. Another 12 patients were treated with ceftriaxone 1-2 g per day intravenously for 10-21 days.

Results

After a median follow up of 18,3 months all patients of the penicillin-treated group and 11 of 12 ceftriaxone-treated patients showed a ≥ 4-fold decline in VDRL-titers; 91% of them already within 6 months after therapy.

Conclusion

Our serological data demonstrate a comparable efficacy of currently recommened penicillin and ceftriaxone treatment regimens for active syphilis in HIV-infected patients.

Johns DR, Tierny M, Felsenstein D: Alterations in the natural history of neurosyphilis by concurrent infection with the human immundeficiency virus. N Engl J Med 1987, 316: 1569–72. 10.1056/NEJM198706183162503PubMedCrossRef

Gregory N, Sanchez M, Buchness MR: The spectrum of syphilis in patients with human immunodeficiency virus. Am Acad Dermatol 1990, 22: 1061–7. 10.1016/0190-9622(90)70153-9CrossRef

Körber A, Dissemond J, Hillen U, Esser S: HIV- positive patient with multiple ulcerations. Hautarzt 2003, 11: 1098–102.CrossRef

Schöfer H, Imhof M, Thoma-Greber E, Brockmeyer NH, Hartmann M, Gerken G, et al.: Active syphilis in HIV infection: a multicentre retrospective survey. The German AIDS Study Group (GASG). Genitourin Med 1996,72(3):176–81.PubMedCentralPubMed

Gordon SM, Eaton ME, George R, et al.: The response of symptomatic neurosyphilis to high-dose intravenous penicillin G in patients with human immuno-deficiency virus infection. N Engl J Med 1994, 331: 1469–73. 10.1056/NEJM199412013312201PubMedCrossRef

Musher DM, Hamill RJ, Baughn RE: Effect of human immunodeficiency virus (HIV) infection on the course of syphilis and on the response to treatment. Ann Intern Med 1990,113(11):872–81.PubMedCrossRef

Center of Disease Control: CDC genital ulcers-STD treatment guidelines. 2006. [http://www.cdc.gov/STD/treatment/2006/genital-ulcers.htm]

Goh BT, van Voorst Vader PC: European guideline for the management of syphilis. Int J STD & AIDS 2001,12(3):14–26.CrossRef

Smith NH, Musher DM, Huang DB, Rodriguez PS, Dowell ME, Ace W, et al.: Response of HIV-infected patients with asymptomatic syphilis to intensive intramuscular therapy with ceftriaxone or procaine penicillin. Int J STD & AIDS 2004, 15: 328–32. 10.1258/095646204323012823CrossRef

10.

Marra CM, Maxwell CL, Tantalo L, Eaton M, Rompalo AM, Raines C, et al.: Normalization of cerebrospinal fluid abnormalities after neurosyphilis therapy: Does HIV status matter? Clin Infect Dis 2004, 38: 1001–6. 10.1086/382532PubMedCrossRef

11.

Dowell E, Ross PG, Musher DM, Cate TR, Baughn RE: Response of latent syphilis or neurosyphilis to ceftriaxone therapy in persons infected with human immunodeficiency virus. Am J Med 1992,93(5):481–8. 10.1016/0002-9343(92)90574-UPubMedCrossRef

12.

Augenbraun M: Treatment of Syphilis 2001: Nonpregnant adults. Clin Infect Dis 2002,35(2):187–90. 10.1086/342106CrossRef

13.

Musher DM: Syphilis, neurosyphilis, penicillin and AIDS. J Infect Dis 1991, 163: 1201–6. 10.1093/infdis/163.6.1201PubMedCrossRef

14.

Berry CD, Hooton TM, Collier AC, Lukehart SA: Neurological relapse after benzathine penicillin therapy for secondary syphilis in a patient with HIV infection. N Engl J Med 1987, 316: 1587–9. 10.1056/NEJM198706183162507PubMedCrossRef

15.

Parkes R, Renton A, Meheus A, Laukamm-Josten U: Review of current evidence and comparison of guidelines for effective syphilis treatment in Europe. Int J STD & AIDS 2004, 15: 73–88. 10.1258/095646204322764253CrossRef

16.

Rolfs RT, Joesoef MR, Hendershot EF, Rompalo AM, Augenbraun MH, Chiu M, et al.: A randomized trial of enhanced therapy for early syphilis in patients with and without human immunodeficiency virus infection. The Syphilis and HIV Study Group. N Engl J Med 1997,337(5):307–14. 10.1056/NEJM199707313370504PubMedCrossRef

17.

German Society of Sexually Transmitted Diseases: Diagnosis and therapy of syphilis. 2008. [http://www.uni-duesseldorf.de/WWW/AWMF/II/059–002.htm]

18.

Stoner BP: Current controversies in the management of adult syphilis. Clin Infect Dis 2007,44(3):130–46. 10.1086/511426CrossRef

19.

Marra CM, Boutin P, McArthur JC, Hurwitz S, Simpson PA, Haslett JA, et al.: A pilot study evaluating ceftriaxone and penicillin G as treatment agents for neurosyphilis in human immunodeficiency virus-infected individuals. Clin Infect Dis 2000,30(3):540–4. 10.1086/313725PubMedCrossRef

20.

Schöfer H, Vogt HJ, Milbradt R: Ceftriaxone for the treatment of primary and secondary syphilis. Chemotherapy 1989, 35: 140–5. 10.1159/000238661PubMedCrossRef

21.

Walter T, Lebouche B, Miailhes P, Cotte L, Roure C, Schlienger I, et al.: Symptomatic relapse of neurologic syphilis after benzathine penicillin G therapy for primary or secondary syphilis in HIV-infected patients. Clin Infect Dis 2006, 43: 787–90. 10.1086/507099PubMedCrossRef

Titel: Response of HIV-infected patients with syphilis to therapy with penicillin or intravenous ceftriaxone
verfasst von: P Spornraft-Ragaller
S Abraham
C Lueck
M Meurer
Publikationsdatum: 01.12.2011
Verlag: BioMed Central
Erschienen in: European Journal of Medical Research / Ausgabe 2/2011
Elektronische ISSN: 2047-783X
DOI: https://doi.org/10.1186/2047-783X-16-2-47

Springer Medizin

Abstract

Background

Methods

Results

Conclusion

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