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A recent small randomized trial has indicated that oral cefixime, a third-generation cephalosporin, demonstrates comparable success rates to penicillin in the treatment of early syphilis. This development offers a potentially significant alternative to traditional treatments, addressing common challenges such as penicillin shortages, allergies, and patient reluctance towards injections.
Cefixime, an FDA-approved and widely accessible medication included on the World Health Organization’s list of essential medicines, could streamline syphilis treatment. The study, which aims to provide results within six months rather than the usual 12, has shown promising early outcomes.
The trial, conducted between 2018 and 2022, comes at a time when syphilis cases are on the rise. Data indicates a nearly 77% increase in syphilis cases during this period, with a 17.2% increase in primary and secondary syphilis among women aged 15 to 44 between 2021 and 2022. As of May 2024, 145 participants have been enrolled, with over two-thirds being people living with HIV.
The study found that at three or six months post-treatment, 87.5% of the 56 patients treated with cefixime, 89.2% of the 49 patients treated with benzathine penicillin G, and all seven patients treated with doxycycline showed at least a fourfold reduction in rapid plasma reagin (RPR) titers.
These findings align with earlier research, where 87% of patients treated with oral cefixime showed successful outcomes, compared to 93% of those treated with penicillin.
Since 2021, the trial has reported minimal adverse events (AEs) in both the cefixime and penicillin treatment groups, with only three mild skin rashes observed in the cefixime group and a high adherence rate to the medication.
The potential for an effective oral alternative to penicillin could significantly improve syphilis treatment accessibility and adherence, particularly in areas facing penicillin shortages or among patients with penicillin allergies.
Disclaimer: This news article is based on information available at the time of publication and reflects the findings of a small, randomized trial. Further research and larger-scale studies are needed to confirm these results and establish cefixime as a standard treatment for early syphilis. Medical information is constantly evolving, and this article should not be considered a substitute for professional medical advice. Individuals with concerns about syphilis or other health issues should consult with a qualified healthcare provider for diagnosis and treatment.
