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Intramuscular benzathine penicillin is the recommended treatment for syphilis, although third-generation cephalosporins represent possible alternatives based on their in vitro activity against Treponema pallidum. One of these agents, cefixime, is orally available and has a pharmacokinetic profile indicating that a twice-daily dose would be therapeutic. Researchers at five community clinics in Los Angeles conducted a randomized, open-label, noncomparative pilot study enrolling 58 HIV-infected patients with primary, secondary, or early latent syphilis and a rapid plasma reagin (RPR) titer ≥1:8. Participants received either 2.4 million units of benzathine penicillin as a single intramuscular injection or oral 400-mg cefixime twice daily for 10…