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Effective initial treatment of syphilis is desirable because opportunity for follow-up is often lacking. A single-dose, oral drug regimen would be advantageous for patients and the healthcare system alike. In a prospective, randomized trial conducted in Tanzania, researchers recently compared a single, 2-g oral dose of azithromycin with the current gold standard, 2.4 MU of injectable penicillin G benzathine.
Three hundred twenty-eight adults with early symptomatic syphilis (diagnosed by PCR on material from genital lesions) or high-titer latent disease (titer ≥1:8 on a rapid plasma reagin test) received either penicillin or manufacturer-supplied azithromycin. Time to cure was shorter in patients with primary syphilis than in those with laten…