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Azithromycin may be a viable alternative to benzathine penicillin G for syphilis treatment
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Oral azithromycin was as safe and effective as benzathine penicillin G for the treatment of early syphilis in patients who did not have HIV, according to study findings.
Oral azithromycin 2 g was randomly assigned as a single dose to 255 participants. Benzathine penicillin G at a dose of 2.4 million units was administered intramuscularly to 262 participants.
The trial was conducted from June 1, 2000, to March 31, 2007, at several locations in the United States and Madagascar.
The aim of the trial was to determine treatment regimens for STDs. The researchers examined serological cure rates for HIV–negative individuals who had early syphilis.
Six-month follow-up results of the intention-to-treat analysis indicated that 180 of 232 patients assigned to azithromycin and 186 of 237 patients assigned to penicillin had serological cure.
Nonserious adverse events were reported in 61.5% of participants in the azithromycin cohort and 46.3% of participants in the penicillin cohort. “Such adverse events were accounted for, in large part, by self-limited gastrointestinal complaints,” the researchers wrote.
Participants in both treatment groups experienced similar rates of serious adverse events. The researchers suggested that the serious adverse events were unrelated to the study drugs and that azithromycin was relatively well tolerated.
Hook EW. J Infect Dis. 2010;201:1729-1735.