Cefixime: Might It Be an Option for Treating Early Syphilis?

In a small randomized open-label trial, oral cefixime was as effective as a single injection of penicillin for treating early syphilis.

Along with the rise in cases of syphilis, the shortage of benzathine penicillin G (BPG) has created a need for alternative treatments. Researchers conducted a randomized, open-label study of oral 400-mg cefixime twice daily for 14 days versus 2.4 million units of intramuscular BPG in adults with primary, secondary, or early latent syphilis. The primary outcome was a ≥4-fold reduction in the Venereal Disease Research Laboratory test (VDRL) titer at 3 months compared with baseline. A secondary outcome was a ≥4-fold VDRL reduction at 12 months.

Among 58 participants who completed the study, 73% of the cefixime group and 87% of the BPG group reached the primary endpoint. After 12 months, the secondary endpoint was attained in 93% and 97% of the …

Reviewing Author

George Sakoulas, MD

Disclosures

Consultant/Advisory BoardParatek Pharmaceuticals; Nestle Corp.; AbbVie; Shionogi

Speaker’s BureauAllergan/AbbVie; Paratek Pharmaceuticals; Nestle Corp.

RoyaltiesUpToDate

Editorial BoardsAntimicrobial Agents and Chemotherapy; Open Forum Infectious Diseases