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Intramuscular benzathine penicillin has been the mainstay of syphilis treatment for decades. Although alternative treatments exist for most disease stages, few alternatives have been validated in large trials.
Japanese researchers retrospectively reviewed the records of 286 HIV-positive men with syphilis who were treated with daily oral amoxicillin (3 g) combined with probenecid between 2000 and 2014. Most patients (70%) had primary, secondary, or early latent disease. Among those with late latent disease, none were known to have neurosyphilis, although cerebrospinal fluid was examined in only a few. Treatment duration usually was 2 weeks, although some patients were treated for as long as 1 month.
Standard serologic criteria (at least a four…