tetracycline and Syphilis

Parenteral penicillin is the first-line regimen for treating syphilis. However, allergic reactions and poor drug tolerance still present challenging problems with respect to use of this antibiotic. This study aimed to evaluate the efficacy and safety of ceftriaxone, erythromycin, minocycline, tetracycline, and doxycycline for syphilis treatment, compared with penicillin, to determine which antibiotic could be a better substitute for penicillin. This study included 17 articles, comprising 3 randomized controlled trials (RCTs) and 14 observational studies and involving 4,485 syphilis patients. Estimated risk ratios (RRs) and 95% confidence interval (CIs) were used to compare the serological response rates. At the 6- and 12-month follow-ups, the serological response rates were compared by direct meta-analysis and network meta-analysis (NMA). Based on direct meta-analysis, the serological response rates at the 3- and 24-month follow-ups were compared. Our NMA showed a higher serological response rate for ceftriaxone than for penicillin at the 6-month follow-up (RR of 1.12, 95% CI of 1.02 to 1.23). Ceftriaxone was equally effective as penicillin for syphilis in terms of serological response rates, and it was a better substitute for penicillin than ceftriaxone, erythromycin, minocycline, tetracycline, or doxycycline. However, more large-scale, high-quality, double-blind trials are still needed to determine whether ceftriaxone can safely replace penicillin for the treatment of syphilis when necessary.

Topics: Anti-Bacterial Agents; Ceftriaxone; Doxycycline; Erythromycin; Humans; Hypersensitivity; Minocycline; Network Meta-Analysis; Observational Studies as Topic; Penicillins; Randomized Controlled Trials as Topic; Syphilis; Tetracycline

Parenteral penicillin is the first-line regimen for treating syphilis, but unsuitable for some patients due to penicillin allergy and lacking health resources. Unfortunately, the efficacy of penicillin alternatives remains poorly understood. This study aimed to assess the efficacy of ceftriaxone and doxycycline/tetracycline in treating early syphilis relative to that of penicillin, and thereby to determine which antibiotic is a better replacement for penicillin.. By searching literature from PubMed, Cochrane Central Register of Controlled Trials, Embase, the Web of Science, and ClinicalTrials.gov and systematically screening relevant studies, eligible randomized controlled trials (RCTs) and observational studies on treatments with penicillin, doxycycline/tetracycline, and ceftriaxone for early syphilis were identified and combined in this systematic review. Estimated risk ratios (RRs) and 95% confidence intervals (CIs) were utilized to compare their serological response and treatment failure rates. At 12-month follow up, serological response rates were compared by a direct meta-analysis and network meta-analysis (NMA), while treatment failure rates were compared with a direct meta-analysis.. Three RCTs and seven cohort studies were included in this research. The results of NMA demonstrated that no significant differences existed in serological response rate at 12-month follow-up between any two of the three treatments (doxycycline/tetracycline vs. penicillin RR = 1.01, 95%CI 0.89-1.14; ceftriaxone vs. penicillin RR = 1.00, 95%CI 0.89-1.13; ceftriaxone vs. doxycycline/tetracycline RR = 0.99, 95%CI 0.96-1.03), which was consistent with the outcomes of the direct meta-analysis. In addition, the direct meta-analysis indicated that, at 12-month follow-up, penicillin and ceftriaxone treatment groups had similar treatment failure rates (RR = 0.92, 95%CI 0.12-6.93), while treatment failure rate was significantly lower among penicillin recipients than among doxycycline/tetracycline recipients (RR = 0.58, 95%CI 0.38-0.89).. Ceftriaxone is as effective as penicillin in treating early syphilis with regard to serological response and treatment failure rate. Compared with doxycycline/tetracycline, ceftriaxone appears to be a better choice as the substitution of penicillin.

Topics: Anti-Bacterial Agents; Ceftriaxone; Drug Therapy, Combination; Humans; Observational Studies as Topic; Penicillins; Randomized Controlled Trials as Topic; Syphilis; Tetracycline; Treatment Outcome

Topics: Cephalosporins; Chlamydia Infections; Clavulanic Acid; Clavulanic Acids; Female; Gonorrhea; Humans; Male; Microbial Sensitivity Tests; Neisseria gonorrhoeae; Penicillanic Acid; Penicillin Resistance; Penicillins; Pharyngeal Diseases; Quinolines; Spectinomycin; Sulbactam; Syphilis; Tetracycline

Topics: Anti-Bacterial Agents; Erythromycin; Humans; Penicillin G Benzathine; Penicillin G Procaine; Syphilis; Syphilis Serodiagnosis; Tetracycline

Clinical manifestations of primary, secondary, congenital, and late syphilis are described. Darkfield examination is the most important laboratory method for diagnosis of primary syphilis. The VDRL and FTA-ABS are the most common serologic tests used for diagnosis and follow-up. Penicillin remains the treatment of choice in nonallergenic patients.

Topics: Adolescent; Adult; Erythromycin; Female; Fluorescent Antibody Technique; Homosexuality; Humans; Male; Penicillin G; Sexual Behavior; Syphilis; Syphilis Serodiagnosis; Syphilis, Congenital; Syphilis, Latent; Tetracycline

Topics: Anti-Bacterial Agents; Chancroid; Female; Gonorrhea; Granuloma Inguinale; Humans; Infant; Infant, Newborn; Lymphogranuloma Venereum; Male; Penicillins; Pregnancy; Sexually Transmitted Diseases; Syphilis; Syphilis, Congenital; Tetracycline

Topics: Ampicillin; Culture Techniques; Female; Gonorrhea; Humans; Metronidazole; Neisseria gonorrhoeae; Penicillin G Procaine; Sexually Transmitted Diseases; Sulfisoxazole; Syphilis; Syphilis Serodiagnosis; Tetracycline; Treponema pallidum

Penicillin remains the treatment of choice for syphilis, with sustained low blood levels curing virtually all patients having early syphilis and halting disease progression in most patients with symptomatic syphilis. Tetracycline, erythromycin or cephalothin yields similar cure rates for patients with early syphilis who are allergic to penicillin. The efficacy of non-penicillin regimens for the treatment of late syphilis is uncertain. Results of Venereal Disease Research Laboratory (VDRL) or other reagin tests should become negative or remain at very low titer following adequate therapy, although results of Treponema pallidum immobilization (TPI) and fluorescent treponemal antibody-absorbed (FTA-ABS) tests often remain positive.

Topics: Cephalexin; Cephaloridine; Cephalosporins; Chloramphenicol; Drug Hypersensitivity; Erythromycin; Female; Fever; Fluorescent Antibody Technique; Follow-Up Studies; Humans; Neurosyphilis; Penicillin G Benzathine; Penicillins; Pregnancy; Pregnancy Complications, Infectious; Pregnancy Trimester, First; Syphilis; Syphilis Serodiagnosis; Syphilis, Cardiovascular; Syphilis, Congenital; Syphilis, Latent; Tetracycline; Treponema pallidum; United States

The role of prophylactic techniques in controlling venereal disease (VD) continues to be disputed despite the fact that prophylactic techniques have been used for centuries. Focus in this discussion is on the effectiveness of available prophylactic methods and some factors influencing the impact of effective prophylaxis on disease control. For practical purposes there are 3 categories of personal prophylaxis: mechanical (of which the condom is most important), locally acting measures, and systemic chemotherapy. Fallopio reported in the 16th century the 1st use of the condom to protect 1100 men from syphilis. Since then the condom has been an important element of many control programs. Condoms should be undamaged, of good quality, and used at the right time in the correct manner. Frequently the condom fails to prevent VD because of deficiencies in these conditions. Several studies have suggested that the condom may be of prophylactic value: venereal infection was detected in 9.5% of those using a condom or early treatment, but in 22% of those using inadequate prophylaxis and in 68.5% of those using none. There is inadequate evidence to support the effectiveness of available local acting prophylactic agents. Systemic antibiotics offer an effective form of prophylaxis. In addition, due to their potent specific antimicrobial properties, systemic antibiotics offer the unique advantage of aborting infection when administered a considerable time after exposure. A recent study demonstrated that 200 mgm minocycline, given as a postexposure prophylactic, decreased the attack rate of gonococcal urethritis by 55%, but those patients developed infection experienced a prolonged incubation period and tended to be infected with relatively resistant strains. These findings suggest the possibility of a more serious sequel: production of a chronic asymptomatic carrier state. Abortive VD therapy in managing a rape victim requires special consideration. Assessment of management should be based on the following: the likelihood of infection, the risks of treatment, the efficacy of treatment, and patient follow-up. Even when safe and effective techniques are available, their impact on VD control may be minimal if they are only rarely used. In many environments condom use ranges 3-20% among VD clinic patients and rarely exceeds 25% in the general male population. Condoms are used least by those who need them most. If utilization is to be increased, the motiv

Topics: Chloramphenicol; Contraceptive Devices, Male; Female; Follow-Up Studies; Gonorrhea; Humans; Iodobenzoates; Male; Methods; Penicillin G; Rape; Sex Work; Sexually Transmitted Diseases; Silver Nitrate; Soaps; Syphilis; Tetracycline; Time Factors; Urination

Topics: Adolescent; Adult; California; Gonorrhea; Humans; Male; Middle Aged; Penicillin G Procaine; Syphilis; Tetracycline

Topics: Anti-Bacterial Agents; Gonorrhea; Greenland; History, 20th Century; Humans; Penicillins; Syphilis; Tetracycline

Topics: Adolescent; Adult; Age Factors; Chloramphenicol; Female; Gonorrhea; Humans; Immunization; Male; Penicillins; Prognosis; Sex Factors; Sex Work; Sexual Behavior; Sexually Transmitted Diseases; Social Medicine; Syphilis; Tetracycline

Topics: Cephaloridine; Collagen Diseases; Complement Fixation Tests; Diagnosis, Differential; Erythromycin; False Negative Reactions; False Positive Reactions; Female; Fluorescent Antibody Technique; Follow-Up Studies; Humans; Infant; Methods; Penicillins; Precipitin Tests; Pregnancy; Pregnancy Complications, Infectious; Syphilis; Syphilis Serodiagnosis; Syphilis, Congenital; Syphilis, Latent; Tetracycline; Treponema Immobilization Test; Treponema pallidum

Topics: Acne Vulgaris; Adult; Aged; Child, Preschool; Female; Gonorrhea; Hirsutism; Humans; Ichthyosis; Infant; Male; Melphalan; Middle Aged; Psoriasis; Sarcoidosis; Skin Diseases; Skin Neoplasms; Syphilis; Tetracycline; United States

Topics: Antifungal Agents; Candidiasis, Vulvovaginal; Female; Glucocorticoids; Gonorrhea; Haemophilus Infections; Herpes Simplex; Humans; Infant, Newborn; Infant, Newborn, Diseases; Metronidazole; Mycoplasma Infections; Ophthalmia Neonatorum; Penicillin G Procaine; Pregnancy; Pregnancy Complications, Infectious; Pregnancy in Diabetics; Syphilis; Syphilis Serodiagnosis; Syphilis, Congenital; Tetracycline; Trichomonas Vaginitis; Vaginal Diseases

Topics: Adolescent; Adult; Aged; Animals; Cat-Scratch Disease; Child; Child, Preschool; Disease Outbreaks; Female; Fever; Gastroenteritis; Humans; Indians, North American; Insect Vectors; Leukemia; Lymphogranuloma Venereum; Male; Middle Aged; New Mexico; Phagocytosis; Plague; Rodentia; Sciuridae; Siphonaptera; Streptomycin; Syphilis; Tetracycline; Tularemia; Yersinia pestis

Topics: Abortion, Spontaneous; Antibodies; Bacteriuria; Chickenpox; Chromosome Aberrations; Chromosome Disorders; Congenital Abnormalities; Coxsackievirus Infections; Cytomegalovirus; Female; Fetal Death; Fetal Diseases; Hepatitis; Herpesviridae Infections; Hormones; Humans; Influenza, Human; Maternal-Fetal Exchange; Measles; Mumps; Obstetric Labor, Premature; Pneumonia; Poliomyelitis; Pregnancy; Pregnancy Complications, Infectious; Rubella; Smallpox; Smallpox Vaccine; Syphilis; Tetracycline; Toxoplasmosis; Toxoplasmosis, Congenital

Topics: Cephalosporins; Clinical Trials as Topic; Drug Combinations; Erythromycin; Female; Gonorrhea; Humans; Male; Penicillin G Procaine; Penicillins; Probenecid; Sexually Transmitted Diseases; Spectinomycin; Syphilis; Syphilis, Congenital; Tetracycline; Time Factors; Urethritis

Topics: Ampicillin; Costs and Cost Analysis; Drug Hypersensitivity; Drug Synergism; Female; Genetics, Microbial; Gonorrhea; Humans; Male; Molecular Biology; Neisseria gonorrhoeae; Penicillin G Benzathine; Penicillin G Procaine; Penicillin Resistance; Penicillins; Placebos; Probenecid; Spectinomycin; Syphilis; Tetracycline; United States

Topics: Administration, Oral; Anti-Bacterial Agents; Clinical Trials as Topic; Erythromycin; Female; Humans; Infusions, Parenteral; Male; Maternal-Fetal Exchange; Penicillin G Benzathine; Penicillin G Procaine; Penicillins; Pregnancy; Syphilis; Syphilis Serodiagnosis; Tetracycline; Time Factors; Treponema Immobilization Test; Treponema pallidum

Topics: Aluminum; Chloramphenicol; Female; Gonorrhea; Humans; Male; Penicillin G Benzathine; Penicillin G Procaine; Stearic Acids; Syphilis; Tetracycline

Congenital syphilis remains a significant cause of newborn mortality and long-term neurodevelopmental problems in some low- and middle-income countries. This study was done in Honiara, Solomon Islands to determine the incidence of babies born to mothers with a positive venereal disease research laboratory (VDRL) test and a positive Treponema pallidum haemagglutination assay (TPHA); to determine the VDRL status of newborns and features of congenital syphilis; and to estimate the proportion of stillbirths associated with syphilis.. All neonates born to VDRL-positive mothers, including stillbirths were included between April and July 2019. Neonates were examined, investigated and treated.. Among 1534 consecutive births, 1469 were live births and 65 (4.2%) were stillbirths. One hundred and forty-three neonates were born to VDRL-positive mothers: 130 (90.1%) were live infants and 13 (8.9%) stillbirths. Of the 130 VDRL-exposed live-born infants, 72 (55%) had reactive VDRL and a positive TPHA and 7 (9.7%) had clinical signs of congenital syphilis. Five of the infants with clinical signs of syphilis infection had a 4-fold higher VDRL titre than their mother. Four infants of VDRL-positive mothers died during admission, all of whom had clinical signs of syphilis. Ninety percent of affected infants were born to mothers who were not treated or only partially treated during pregnancy.. In this study, 1:210 live-born babies had clinical and serological evidence of congenital syphilis, and evidence of Treponema infection was found disproportionately in stillbirths. In a setting where Treponema infections are common, an empirical approach to prevention may be needed.

Topics: Female; Humans; Infant; Infant Mortality; Infant, Newborn; Male; Melanesia; Penicillins; Pregnancy; Pregnancy Complications, Infectious; Stillbirth; Syphilis; Syphilis Serodiagnosis; Syphilis, Congenital; Tetracycline; Treatment Outcome; Treponema pallidum; Yaws

The increased prevalence of syphilis in Cuba prompted us to map the circulating Treponema pallidum subsp. pallidum allelic profiles in this geographic region.. Samples were collected from 2012 to 2017, from 83 male patients with ulcers or skin lesions, and were examined using multilocus sequence typing. Additionally, we analyzed the 23S rDNA and 16S rDNA regions for the presence of possible mutations leading to macrolide and tetracycline resistance.. Among 94% of fully typed strains, we found 7 different allelic profiles, of which 4 had not been previously described. More than 87% of patients were infected with the T. pallidum SS14-like group and only 8.2% with T. pallidum Nichols-like group. As in other countries, the 1.3.1 allelic profile (ie, SS14-like) was the most common. In addition, 1 of the newly described allelic profiles represents T. pallidum strains that arose by recombination events between members of different T. pallidum subgroups. More than 90% of patients were infected with treponemes harboring the A2058G mutation. However, we found no potential tetracycline-resistant T. pallidum mutations.. Our results suggest that, in Cuba, tetracycline antibiotics could be used to treat syphilis in penicillin-allergic patients instead of macrolides.

Topics: Adult; Alleles; Anti-Bacterial Agents; Bacterial Typing Techniques; Cuba; Drug Resistance, Bacterial; Humans; Macrolides; Male; Multilocus Sequence Typing; Mutation; Syphilis; Tetracycline; Treponema pallidum

Benzathine penicillin G is the treatment of choice for syphilis, but doxycycline and tetracycline are effective second-line treatments. The objective of this study was to assess the serological response to treatment for early syphilis with benzathine penicillin compared with doxycycline or tetracycline.. We examined rapid plasma regain (RPR) serological test results of all first-time early syphilis patients in Peking Union Medical College Hospital between 2000 and 2011, comparing treatment with two doses of penicillin to 14-day course of oral doxycycline (100 mg twice daily) or oral tetracycline (500 mg 4 times a day).. Of the 641 early syphilis cases with available treatment outcome data, 606 (94.5%) received penicillin and 35 (5.5%) received doxycycline/tetracycline. More than half (52.1%) had secondary syphilis, 13.4% had primary syphilis, and 34.5% had early latent syphilis. A statistically similar serological treatment success rate (p = 0.157) was observed in penicillin-treated patients 91.4% (554/606), when compared with patients treated with doxycycline/tetracycline 82.9% (29/35).. Doxycycline/tetracycline had a similar serological treatment success rate when compared to penicillin in the treatment of early syphilis.

Topics: Administration, Oral; Adolescent; Adult; Aged; Aged, 80 and over; Anti-Bacterial Agents; Doxycycline; Female; Humans; Male; Middle Aged; Penicillin G Benzathine; Retrospective Studies; Serologic Tests; Syphilis; Tetracycline; Treatment Outcome; Young Adult

There is no straightforward test available, within weeks of treatment for syphilis, to assess adequacy of serologic response. We propose a method to predict non-treponemal seroreversion based on short term response. To develop and illustrate this method, we used data from 370 individuals with infectious syphilis. Individual serologic response appears to be a linear function of (log) time, suggesting the possibility of using rapid plasma reagin titres recorded in the first few months after treatment to determine the slope of the linear treatment response line. The slope of the response line, during the first year after treatment, is an important predictor of seroreversion but must be considered in conjunction with pre-treatment titre. We recommend development of an action line be developed based on these variables. Such a line would indicate the necessity for retreatment if the line plotted from the patient's first year response failed to fall below the action line.

Topics: Adult; Female; Follow-Up Studies; Humans; Male; Middle Aged; Models, Statistical; Penicillins; Proportional Hazards Models; Reagins; Recurrence; Syphilis; Tetracycline; Treatment Outcome

IgG antibodies from mothers adequately treated for syphilis can cross the placenta and appear in the sera of healthy newborns without infection. In such infants, a false diagnosis of congenital syphilis is often made. We have designed a retrospective survey to determine the time of seroreversion of the serological tests for syphilis (STS) in uninfected newborns born to mothers who were adequately treated for syphilis.. Fifty two seropositive, untreated newborns born to 51 mothers treated for syphilis were studied. The newborns were followed at 1, 3, 6, 9, and 12 months of age until seroreversion was detected. The VDRL test was followed until 12 months in 12 of the 22 newborns who were positive at birth, the TPHA in 21 of the 46 newborns, and the FTA-ABS test in 22 of the 48 newborns.. In the first serological tests done within 1 month after birth, the VDRL was positive in 22 newborns (42%), the TPHA in 46 (88%), and FTA-ABS in 48 (92%). The VDRL seroreverted within 6 months after birth in 84%, and within 1 year in 100%. The TPHA test seroreverted in 95% within 1 year after birth. The FTA-ABS test seroreverted in 100% within 1 year after birth.. In most seropositive, untreated newborns born to treated mothers the VDRL became negative within 6 months after birth and the TPHA and FTA-ABS within 1 year. This result is consistent with current Centers for Disease Control (CDC) guidelines. However, although the CDC guidelines are adequate in general, we think that some revision is desirable concerning the IgM test and combination of the test results in order to rule out congenital syphilis in seropositive, nonsymptomatic newborns born to the treated mothers.

Topics: Female; Humans; Immunoglobulin G; Infant, Newborn; Penicillins; Pregnancy; Pregnancy Complications, Infectious; Retrospective Studies; Syphilis; Syphilis Serodiagnosis; Syphilis, Congenital; Tetracycline; Time Factors; Treponema pallidum

Dade County sexually transmitted disease clinic records were reviewed to estimate the relative effectiveness of gonorrhea treatment regimens for eradicating incubating syphilis. Records were searched to see if persons treated for gonorrhea returned with primary syphilis 3-45 days after treatment or secondary syphilis 15-90 days after treatment. The number of persons treated was adjusted for the prevalence of syphilis in the year of treatment. Between 1985 and 1992, 98,441 persons were treated for gonorrhea. Syphilis was diagnosed in an interval that suggested it was incubating at the time of the treatment for 5.6/10(4) (adjusted number) persons treated with spectinomycin alone (a regimen not expected to eradicate syphilis); 2.9/10(4) persons treated with spectinomycin plus tetracycline, doxycycline, or erythromycin; and 2.1/10(4) persons treated with ceftriaxone plus tetracycline, doxycycline, or erythromycin (P > .1). Incubating syphilis was rare despite a syphilis epidemic. The effectiveness of a regimen for eradicating incubating syphilis should not be a major consideration when choosing gonorrhea therapy.

Topics: Ceftriaxone; Doxycycline; Drug Therapy, Combination; Erythromycin; Florida; Follow-Up Studies; Gonorrhea; Humans; Incidence; Medical Records; Prevalence; Risk Factors; Syphilis; Tetracycline

Asymptomatic syphilis eventually manifesting with symptoms of the secondary disease was observed in a male with HIV-infection. Large focuses of alopecia reported in this male are suggested as a clinical marker of HIV-infection. A defective antibody response to T. pallidum in HIV-infection has been confirmed. Levomycetin (0.5 g 4 times a day in 5-20-day courses at two-week intervals) proved highly effective as compared to penicillin, erythromycin and tetracycline administration due to poor tolerance of the above antibiotics.

Topics: Adult; Chloramphenicol; Drug Therapy, Combination; Erythromycin; Histamine H1 Antagonists; HIV Infections; HIV-1; Hospitalization; Humans; Male; Recurrence; Syphilis; Tetracycline

A case of an HIV positive man with multiple sexually acquired disease occurring concurrently is described. Risk behaviours that could have predisposed him to HIV infection are discussed. The factors which might have interacted to make the sexually acquired infections severe and difficult to treat are postulated.. The case of an HIV-seropositive man with gonorrhea, syphilis, genital warts, and chancroid is described. Multiple sexual partners, genital ulcer diseases, and lack of circumcision may have predisposed him to HIV infection. As indicated by his CD4/CD8 ratio of 0.5, his immunological status was not very compromised. Other factors were therefore probably behind these multiple sexually transmitted diseases (STD). This 30-year old man was inadequately treated for a long time for urethral discharge and genital ulcer disease, and ultimately collapsed on the job with a comprised central nervous system. Bacterial infection related to the multiple STDs could certainly have caused this collapse. The time demands of this man's work, the lack of medical facilities to diagnose and treat such conditions, his unprotected sexual behavior with multiple partners, and broader socioeconomic conditions which separate wage- earning males from their families in Africa conspire to produce multiply-afflicted cases such as these.

Topics: Adult; Anti-Infective Agents; Chancroid; Ciprofloxacin; Condylomata Acuminata; Gonorrhea; HIV Seropositivity; Humans; Injections, Intravenous; Kenya; Male; Risk Factors; Sexually Transmitted Diseases; Syphilis; Tetracycline

A total of 156 patients with early syphilis were treated with tetracyclin and oletetrin. The drugs were administered 4 times daily (every 6 hrs) in a dose of 0.5 g (daily dose 2.0 g). Patients with primary seropositive syphilis were treated for 20 days, the dose per course being 40 g, those with secondary fresh syphilis for 25 days, dose per course 50 g, those with secondary recurring syphilis for 40 days, dose per course 80 g. The treatment was well tolerated by all the patients. Early negative results of specific serologic tests after treatment confirm the efficacy of the suggested method.

Topics: Adolescent; Adult; Antibodies, Bacterial; Drug Evaluation; Drug Therapy, Combination; Female; Humans; Male; Middle Aged; Oleandomycin; Recurrence; Syphilis; Syphilis Serodiagnosis; Tetracycline; Time Factors; Treponema pallidum

Topics: Anti-Bacterial Agents; Erythromycin; Female; Gonorrhea; Humans; Male; Syphilis; Tetracycline

The results of rapid single-course oletetrine and tetracycline therapy of early syphilis are analyzed. The time of Treponema pallidum disappearance from syphilid discharge, of syphilid regression, and of the first negative results of the routine serologic tests, immunofluorescence 200/ABC and T. pallidum immobilization tests, as well as the blood serum tetracycline level indicate a high therapeutic efficacy of this method and recommend it for wide use.

Topics: Adult; Drug Evaluation; Drug Therapy, Combination; Female; Humans; Male; Middle Aged; Oleandomycin; Remission Induction; Syphilis; Syphilis Serodiagnosis; Tetracycline; Time Factors

Topics: Adult; Bismuth; Drug Evaluation; Drug Therapy, Combination; Erythromycin; Female; Follow-Up Studies; Humans; Male; Middle Aged; Oleandomycin; Recurrence; Syphilis; Syphilis Serodiagnosis; Tetracycline; Time Factors

Syphilis, a sexually transmitted disease caused by Treponema pallidum, is widespread but most common in large cities. The various stages include primary, secondary, latent, tertiary (late), and congenital syphilis and neurosyphilis. Definitive diagnosis is made by finding spirochetes on a darkfield examination of material from a chancre or moist mucosal lesion. Serologic tests for syphilis in common use in the United States include the VDRL and the FTA-ABS. Penicillin is the drug of choice for all stages of syphilis, with tetracycline or erythromycin indicated in certain patients. Accurate and prompt reporting of syphilis cases is an important factor in disease control.

Topics: Female; Humans; Male; Neurosyphilis; Penicillin G; Syphilis; Syphilis Serodiagnosis; Syphilis, Congenital; Syphilis, Latent; Tetracycline; Treponema pallidum

Topics: Cephalosporins; Chloramphenicol; Drug Hypersensitivity; Erythromycin; Humans; Penicillins; Spectinomycin; Syphilis; Tetracycline

A case of Fitz-Hugh Curtis syndrome caused by chlamydia is described in which the perihepatic and abdominal swelling also extended to the right perirenal tissue. The case was diagnosed on the basis of the clinical picture, the behaviour of anti-chlamydia serum antibodies, abdominal echography and laparoscopy. The infection was quickly cured by the administration of tetracycline.

Topics: Adult; Chlamydia Infections; Condylomata Acuminata; Female; Hepatitis; Hepatitis, Chronic; Heroin Dependence; Humans; Salpingitis; Syndrome; Syphilis; Tetracycline; Vaginal Neoplasms

One important aspect of the posttreatment evaluation of patients with early syphilis is assessment of serological test results. Using information previously collected from 818 patients in the Early Syphilis Study, we evaluated the seroresponse of people treated for primary or secondary syphilis. We generated curves describing the VDRL titer declines with time. The VDRL titer declined approximately fourfold at three months and eightfold at six months. These observations will allow clinicians to identify treatment failures or reinfections at the earliest possible time during their follow-up.

Topics: Antibodies, Bacterial; Drug Therapy, Combination; Erythromycin; Humans; Models, Theoretical; Penicillins; Recurrence; Spectinomycin; Syphilis; Syphilis Serodiagnosis; Tetracycline; Time Factors

Topics: Adult; Homosexuality; Humans; Lung Diseases; Male; Radiography, Thoracic; Syphilis; Tetracycline; Tomography, X-Ray Computed

Topics: Administration, Oral; Adult; Female; Humans; Male; Reagins; Reference Values; Syphilis; Tetracycline

Topics: Head; Humans; Neck; Penicillin G; Penicillin G Benzathine; Pinta; Prednisone; Syphilis; Temporal Bone; Tetracycline; Treponemal Infections; Yaws

Topics: Erythromycin; Humans; Immunity, Cellular; Norway; Penicillin G Procaine; Syphilis; Syphilis Serodiagnosis; Tetracycline; Treponema Immobilization Test; Treponema pallidum

Topics: Antibodies, Bacterial; Drug Hypersensitivity; Erythromycin; Humans; Penicillins; Syphilis; Syphilis Serodiagnosis; Tetracycline; Treponema Immobilization Test; Treponema pallidum

Topics: Adult; Biopharmaceutics; Bismuth; Drug Therapy, Combination; Humans; Middle Aged; Oleandomycin; Recurrence; Syphilis; Syphilis Serodiagnosis; Tetracycline

We have briefly presented practical approaches to the management of the most common disorders caused by sexually transmitted pathogens, including pelvic inflammatory disease, urethritis in men, genital lesions, vaginal discharge, and syphilis. Guidelines for the management of gonorrhea may change if penicillin-resistant strains become more prevalent. Areas which require further research include the treatment of genital herpes and the prevention of recurrences, the treatment of nonspecific vaginitis, and definition of the importance of metronidazole toxicity.

Topics: Anti-Bacterial Agents; Candidiasis, Vulvovaginal; Female; Genital Diseases, Female; Genital Diseases, Male; Gonorrhea; Herpesviridae Infections; Humans; Male; Pelvic Inflammatory Disease; Penicillin G; Pharyngeal Diseases; Pregnancy; Sexually Transmitted Diseases; Syphilis; Tetracycline; Urethritis; Vaginitis

Topics: Chlamydia Infections; Dimethyl Sulfoxide; Drug Combinations; Female; Gonorrhea; Herpes Simplex; Humans; Idoxuridine; Lymphogranuloma Venereum; Male; Penicillins; Sexually Transmitted Diseases; Syphilis; Tetracycline

The worldwide increase in the incidence of sexually transmitted diseases confronts the physician to an increasing extent with this group of infections. The high morbidity and the change in the clinical picture of gonorrhea, especially its asymptomatic form, give rise to extragenital complications which frequently lead the patient to the internal specialist in the first instance. Non-gonorrheal urethritis, in particular the infectious form, is undergoing intensive research. A number of organisms may be responsible, but a non-infectious origin must also be kept in mind. Syphilis is still important. The late stages of the disease have become rare thanks to highly effective therapy with antibiotics. The early stages of the infection, however, must always be considered in the differential diagnosis of any genital or anal affection, and also in generalized exanthemas of unknown origin. Homosexual transmission presents diagnostic problems of its own. Serological mass screening is essential. Interpretation of the results must take into account the different specificity of the various serological tests and their indication.

Topics: Erythromycin; Family Practice; Female; Gonorrhea; Hepatitis; Humans; Male; Neisseria gonorrhoeae; Penicillins; Proctitis; Sepsis; Sexually Transmitted Diseases; Syphilis; Tetracycline; Urethritis

In order to get some more information about the kind of treatment of syphilis in the F.R.G. a study among the 1578 practising dermatologists (without members of hospital staff) by means of questionaires was made. 1164 (79%) answered the inquiry. The study shows that nearly 50% of the answering dermatologists treat syphilis by several series of penicillin applications. On the other side, only one third of the respective dermatologists performs treatment by one series, giving penicillin from 15 to 21 Mega units. The study shows that the kind of therapy is rather age-dependend insofar as the older dermatologists prefer the multiple therapy series scheme, whereas the younger dermatologists are inclined to use the single series scheme. Furthermore geographical differences could be shown, e.g. most of the Bavarian dermatologists use the single series scheme. The kind of penicillin, way of application and the time intervals were rather uniform related to regions and schemes of therapy. Tetracycline and Erythromycin are used in case of penicillin allergy. In the opinion of less than 50% of dermatologists additional redications are necessary, whereby the younger ones prefere corticosteroides, the older ones potassium iodide. The benefits of uniformly performed therapy of syphilis by the single series scheme are discussed.

Topics: Adrenal Cortex Hormones; Age Factors; Dermatology; Erythromycin; Humans; Penicillins; Potassium Iodide; Syphilis; Tetracycline; Time Factors

Topics: Erythromycin; Gonorrhea; Humans; Penicillin G; Syphilis; Tetracycline

Topics: Administration, Oral; Drug Administration Schedule; Erythromycin; Female; Follow-Up Studies; Humans; Infant, Newborn; Injections, Intramuscular; Neurosyphilis; Penicillin G; Penicillin G Benzathine; Penicillin G Procaine; Pharmaceutical Vehicles; Pregnancy; Pregnancy Complications, Infectious; Syphilis; Syphilis, Congenital; Syphilis, Latent; Tetracycline

Topics: Erythromycin; Female; Follow-Up Studies; Humans; Infant, Newborn; Male; Penicillin G Benzathine; Penicillin G Procaine; Pregnancy; Pregnancy Complications, Infectious; Syphilis; Syphilis, Congenital; Tetracycline

Topics: Communicable Disease Control; Erythromycin; Female; Government Agencies; Humans; Penicillins; Pregnancy; Pregnancy Complications, Infectious; Syphilis; Tetracycline; United States

Topics: Child; Erythromycin; Female; Humans; Infant, Newborn; Penicillin G; Pregnancy; Syphilis; Tetracycline

Topics: Anti-Bacterial Agents; Chlamydia Infections; Dimethyl Sulfoxide; Female; Gonorrhea; Herpes Simplex; Humans; Idoxuridine; Immunotherapy; Male; Penicillins; Sexually Transmitted Diseases; Syphilis; Tetracycline

Topics: Drug Hypersensitivity; Erythromycin; Female; Humans; Infant, Newborn; Penicillin G Benzathine; Penicillin G Procaine; Penicillins; Pregnancy; Pregnancy Complications; Syphilis; Syphilis, Congenital; Tetracycline

Topics: Anti-Bacterial Agents; Erythromycin; Female; Humans; Infant, Newborn; Male; Penicillins; Pregnancy; Syphilis; Tetracycline

Topics: Erythromycin; Female; Humans; Infant, Newborn; Penicillin G; Pregnancy; Pregnancy Complications, Infectious; Recurrence; Syphilis; Syphilis, Congenital; Syphilis, Latent; Tetracycline

Topics: Ampicillin; Child; Female; Gonorrhea; Humans; Infant, Newborn; Infant, Newborn, Diseases; Male; Pelvic Inflammatory Disease; Penicillin G Procaine; Pharyngitis; Probenecid; Spectinomycin; Syphilis; Tetracycline; United States; United States Public Health Service; Urethritis

In the presence of penicillin allergy early syphilis can be treated with tetracyclines, erythromycin and thiamphenicol. Treatment with semisynthetic penicillins or cephalosporins should not be attempted in view of possible cross-sensitivity. From comparison of different antibiotic treatment schedules in the literature a time-dose relationship seems evident: within therapeutic limits, treatment with a high daily dose of antibiotic requires a relatively short duration, and vice versa. Results of various treatment schedules with different antibiotics suggest that preference should be given to doxycycline by oral route, 100 mg twice daily for 12 days.

Topics: Administration, Oral; Anti-Bacterial Agents; Dose-Response Relationship, Drug; Doxycycline; Drug Hypersensitivity; Erythromycin; Humans; Penicillins; Syphilis; Tetracycline; Thiamphenicol; Time Factors

A case of myositis associated with secondary syphilis is described. Complete recovery occurred after antisyphilitic treatment.

Topics: Humans; Male; Middle Aged; Myositis; Phenylbutazone; Syphilis; Tetracycline

Topics: Epidemiologic Methods; Erythromycin; Female; Humans; Infant, Newborn; Male; Neurosyphilis; Penicillin G Benzathine; Penicillin G Procaine; Pregnancy; Syphilis; Syphilis Serodiagnosis; Tetracycline

Topics: Administration, Oral; Female; Gonorrhea; Humans; Male; Penicillins; Sexually Transmitted Diseases; Syphilis; Tetracycline; Urethritis

Topics: Adolescent; Adult; Age Factors; Female; Gonorrhea; Greenland; Humans; Male; Metronidazole; Middle Aged; Penicillins; Sex Factors; Syphilis; Syphilis Serodiagnosis; Tetracycline; Treponema Immobilization Test

Topics: Erythromycin; Female; Humans; Male; Neurosyphilis; Penicillins; Pregnancy; Syphilis; Syphilis, Cardiovascular; Syphilis, Congenital; Tetracycline

Topics: Anti-Infective Agents; Female; Folic Acid Antagonists; Gonorrhea; Humans; Male; Penicillin Resistance; Penicillins; Pyrimidines; Sulfamethoxazole; Syphilis; Tetracycline; Trimethoprim

Topics: Adolescent; Ampicillin; Anti-Bacterial Agents; Child; Child, Preschool; Denmark; Economics, Medical; Epidemiology; Gonorrhea; Greenland; History, 20th Century; Humans; Infant; Infant, Newborn; Penicillins; Statistics as Topic; Syphilis; Tetracycline

Topics: Erythromycin; Female; Humans; Penicillin G Procaine; Penicillins; Pregnancy; Syphilis; Tetracycline; Treponema pallidum

Topics: Bacteriological Techniques; Benzoates; Female; Gonorrhea; Humans; Iodobenzoates; Jurisprudence; Nevada; Sex Work; Sexually Transmitted Diseases; Syphilis; Tetracycline; Vaginal Smears

Topics: Acute Disease; Ampicillin; Anti-Bacterial Agents; Doxycycline; Gonorrhea; Humans; Penicillins; Probenecid; Syphilis; Tetracycline

Topics: Chancroid; Drug Combinations; Erythromycin; Female; Gonorrhea; Granuloma Inguinale; Humans; Injections, Intramuscular; Kanamycin; Lymphogranuloma Venereum; Male; Metronidazole; Penicillin Resistance; Penicillins; Rifampin; Sexually Transmitted Diseases; Streptomycin; Sulfamethoxazole; Sulfonamides; Syphilis; Tetracycline; Trimethoprim; Urethritis

Topics: Administration, Oral; Biopsy; Chancroid; Drug Tolerance; Evaluation Studies as Topic; Hospitalization; Humans; Lymphogranuloma Venereum; Methylamines; Sexually Transmitted Diseases; Staining and Labeling; Syphilis; Tetracycline; Time Factors

Topics: Administration, Oral; Ampicillin; Anti-Bacterial Agents; Female; Gonorrhea; Humans; Injections, Intramuscular; Male; Penicillin G Procaine; Penicillin Resistance; Probenecid; Spectinomycin; Syphilis; Tetracycline

Topics: Cephaloridine; Erythromycin; False Positive Reactions; Female; Flocculation; Fluorescent Antibody Technique; Humans; Infant, Newborn; Penicillins; Pregnancy; Pregnancy Complications, Infectious; Premarital Examinations; Prenatal Care; Syphilis; Syphilis Serodiagnosis; Syphilis, Congenital; Tetracycline; Treponema Immobilization Test; Treponema pallidum

Topics: Animals; Antigens, Bacterial; Bacterial Vaccines; Bacteriological Techniques; Culture Media; Disease Models, Animal; Female; Haplorhini; Humans; Infant; Infant, Newborn; National Institutes of Health (U.S.); Penicillins; Pregnancy; Rabbits; Syphilis; Syphilis, Congenital; Tetracycline; Treponema; Treponema Immobilization Test; Treponema pallidum; United States

Topics: Administration, Oral; Ampicillin; Anti-Bacterial Agents; Female; Gonorrhea; Humans; Injections, Intramuscular; Male; Penicillin G; Serologic Tests; Syphilis; Tetracycline

Topics: Candidiasis, Vulvovaginal; Female; Gonorrhea; Humans; Male; Pelvic Inflammatory Disease; Penicillin G Procaine; Pharyngitis; Proctitis; Syphilis; Tetracycline; Urogenital System; Vulvovaginitis

Topics: Cervix Uteri; Culture Media; Education, Medical, Continuing; Education, Medical, Graduate; Female; Gonorrhea; Humans; Male; Neisseria gonorrhoeae; Penicillin G Benzathine; Penicillin G Procaine; Programmed Instructions as Topic; Rectum; Staining and Labeling; Syphilis; Tetracycline; Urethritis

Topics: Adolescent; Adult; Drug Hypersensitivity; Female; Follow-Up Studies; Gonorrhea; Humans; Injections, Intramuscular; Male; Middle Aged; Neisseria gonorrhoeae; Penicillin G; Penicillin G Procaine; Penicillin Resistance; Probenecid; Rectum; Streptomycin; Syphilis; Syphilis Serodiagnosis; Tetracycline

Topics: Adolescent; Adult; Ampicillin; Anti-Bacterial Agents; Erythromycin; False Positive Reactions; Female; Fluorescent Antibody Technique; Gonorrhea; Humans; Male; Neurosyphilis; Penicillin G Benzathine; Penicillin G Procaine; Probenecid; Syphilis; Syphilis Serodiagnosis; Syphilis, Cardiovascular; Syphilis, Latent; Tetracycline; United States

Topics: Administration, Oral; Adult; Anti-Bacterial Agents; Arthritis; Cervix Mucus; Female; Gonorrhea; Humans; Neisseria gonorrhoeae; Penicillin Resistance; Penicillins; Probenecid; Recurrence; Statistics as Topic; Syphilis; Tetracycline; United States

Topics: Anti-Bacterial Agents; Female; Gonorrhea; Humans; Male; Neisseria gonorrhoeae; Penicillin G; Penicillin Resistance; Procaine; Rifampin; Streptomycin; Syphilis; Tetracycline

Topics: Adult; Aged; Alopecia; Anti-Bacterial Agents; Balanitis; Biopsy; Child; Child, Preschool; Chloramphenicol; Deoxyuridine; Diagnosis, Differential; Diagnostic Errors; Erythromycin; Exanthema; Female; Hemorrhoids; Hernia, Inguinal; Herpes Simplex; Humans; Lymphadenitis; Male; Metronidazole; Middle Aged; Mycoses; Oxytetracycline; Penicillins; Sarcoidosis; Sclerosis; Skin Tests; Stomatitis; Syphilis; Syphilis Serodiagnosis; Syphilis, Latent; Tetracycline

Topics: Adolescent; Adult; Bacteria; Black People; Carcinoma, Squamous Cell; Female; Granuloma Inguinale; Homosexuality; Humans; Male; Microscopy, Electron; Middle Aged; Penile Neoplasms; Staining and Labeling; Syphilis; Tetracycline

Topics: Anti-Bacterial Agents; Chloramphenicol; Erythromycin; Humans; Injections, Intramuscular; Injections, Intravenous; Oxytetracycline; Penicillins; Rolitetracycline; Syphilis; Tetracycline

Topics: Anti-Bacterial Agents; Female; Gonorrhea; Humans; Male; Naphthacenes; Penicillin G Procaine; Syphilis; Tetracycline

Topics: Bismuth; Cephalosporins; Chloramphenicol; Drug Hypersensitivity; Erythromycin; Female; Humans; Male; Penicillins; Pregnancy; Rolitetracycline; Syphilis; Tetracycline

Topics: Australia; Female; Fluorescent Antibody Technique; Gonorrhea; Humans; Male; Penicillins; Sex Factors; Sexually Transmitted Diseases; Syphilis; Syphilis Serodiagnosis; Syphilis, Congenital; Syphilis, Latent; Tetracycline; Urethritis

Topics: Conjunctivitis; Humans; Male; Middle Aged; Neurosyphilis; Penicillins; Syphilis; Syphilis Serodiagnosis; Tetracycline

Topics: Cephaloridine; Erythromycin; Humans; Penicillins; Syphilis; Tetracycline

Topics: Anti-Bacterial Agents; Erythromycin; Humans; Penicillin Resistance; Penicillins; Spectinomycin; Syphilis; Tetracycline

Topics: Acne Vulgaris; Gonorrhea; Humans; Oleandomycin; Pyoderma; Skin Diseases; Steroids; Syphilis; Tetracycline; Urethritis

Topics: Adolescent; Adult; Diagnosis, Differential; Erythromycin; Female; Gingival Diseases; Humans; Male; Penicillin G Benzathine; Penicillin G Procaine; Syphilis; Syphilis Serodiagnosis; Tetracycline

Topics: Adult; Anus Diseases; Biopsy; Humans; Lymph Nodes; Male; Syphilis; Tetracycline

Topics: Anti-Bacterial Agents; Drug Therapy; Humans; Rolitetracycline; Syphilis; Syphilis Serodiagnosis; Tetracycline

Topics: Aluminum; Child; Chlortetracycline; Ethylenediamines; Humans; Infant; Infant, Newborn; Massachusetts; Neurosyphilis; Oxytetracycline; Penicillin G; Penicillin G Benzathine; Penicillin G Procaine; Penicillin Resistance; Pharmacology; Procaine; Syphilis; Syphilis Serodiagnosis; Syphilis, Congenital; Syphilis, Latent; Tetracycline

Topics: Anterior Spinal Artery Syndrome; Anti-Bacterial Agents; Antibiotics, Antitubercular; Anuria; Arteries; Constipation; Humans; Neurologic Manifestations; Penicillins; Spine; Sulfonamides; Syphilis; Syphilis, Cardiovascular; Tetracycline; Vascular Diseases

Topics: Communicable Disease Control; Ethylenediamines; Humans; Penicillin G; Penicillin G Benzathine; Penicillin G Procaine; Placebos; Procaine; Syphilis; Tetracycline

Topics: Anti-Bacterial Agents; Antibiotics, Antitubercular; Chloramphenicol; Erythromycin; Gonorrhea; Novobiocin; Nystatin; Oleandomycin; Penicillins; Protein Synthesis Inhibitors; Spiramycin; Streptomycin; Sulfonamides; Syphilis; Tetracycline; United Kingdom; Venereology

Topics: Anti-Bacterial Agents; Penicillin G; Penicillin G Procaine; Penicillins; Procaine; Syphilis; Tetracycline; Toxicology

Topics: Anti-Bacterial Agents; Bacillus; Biomedical Research; Brucellosis; Chloramphenicol; Chlortetracycline; Communicable Diseases; Cycloserine; Diphtheria; Dysentery; Dysentery, Bacillary; Erythromycin; Escherichia coli Infections; Humans; Influenza, Human; Liver Extracts; Methicillin; Penicillins; Pneumonia; Research; Staphylococcal Infections; Streptomycin; Syphilis; Tetracycline; Trachoma; Tuberculosis; USSR

Topics: Anti-Bacterial Agents; Chloramphenicol; Erythromycin; Ethylenediamines; Humans; Penicillin G; Penicillin G Benzathine; Penicillin G Procaine; Penicillins; Procaine; Syphilis; Tetracycline

Topics: Anti-Bacterial Agents; Biomedical Research; Female; Humans; Pregnancy; Syphilis; Syphilis, Congenital; Tetracycline

Topics: Anti-Bacterial Agents; Penicillins; Syphilis; Tetracycline

Topics: Anti-Bacterial Agents; Erythromycin; In Vitro Techniques; Penicillins; Streptomycin; Syphilis; Tetracycline; Treponema pallidum

Topics: Anti-Bacterial Agents; Humans; Syphilis; Tetracycline