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Yaws, the spirochetal infection caused by Treponema pallidum subsp. pertenue, primarily affects skin, bones, and cartilage. Without early treatment, it can cause chronic, deforming infection. Nearly eradicated by mass treatment with penicillin injections during the 1950s and 1960s, the disease is reemerging among poor, rural populations in tropical Africa, Asia, and South America.
To assess whether an oral antibiotic works as well as intramuscular penicillin, investigators conducted a prospective, open-label, noninferiority trial in a remote area of Papua New Guinea. Children aged 6 months to 15 years with serologically confirmed yaws were randomized to receive a single dose of oral azithromycin or intramuscular benzathine benzylpenicillin. …