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Benzathine penicillin is the treatment of choice for primary syphilis. However, it has some disadvantages, including cost, injection-site pain, and contraindication in penicillin-allergic patients. Little research has been done on the use of alternative agents, such as doxycycline and tetracycline. Now, in a retrospective cohort study conducted in Alberta, Canada, researchers have compared serologic response rates between patients treated with a single injection of benzathine penicillin and those treated with 14 days of either doxycycline (100 mg twice daily) or tetracycline (500 mg 4 times daily).
Participants had a first-time diagnosis of primary syphilis between 1980 and 2001. Criteria for exclusion included HIV positivity, a nonreactive …