{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T05:10:37Z","timestamp":1788412237832,"version":"build-2803163510"},"reference-count":7,"publisher":"CSIRO Publishing","issue":"6","license":[{"start":{"date-parts":[[2025,8,18]],"date-time":"2025-08-18T00:00:00Z","timestamp":1755475200000},"content-version":"vor","delay-in-days":2118,"URL":"https:\/\/doi.org\/10.1071\/journalslicense"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,11,26]]},"abstract":"<jats:p>Men who have sex with men (MSM) with symptomatic secondary syphilis present with characteristic symptoms of rash, fever and lymphadenopathy; due to delays in microbiology results and some patients failing to return for treatment, empirical treatment is sometimes offered. We reviewed all patients presenting with secondary syphilis diagnosed on the basis of clinical symptoms and signs and reviewed treatment. Of the 36 patients, 16 MSM (44%; 95% confidence interval (CI) 27.8\u201360.2%) were treated empirically, whereas treatment was delayed for 20 (56%; 95% CI 39.8\u201372.2%) waiting for microbiology results. Treatment delays were longer for HIV-negative than HIV-positive MSM (10 vs 5 days respectively; P = 0.01); the cumulative treatment delay was 143 days. Concerns over antimicrobial resistance and overuse of antimicrobials should drive the use of point-of-care testing for syphlis.<\/jats:p>","DOI":"10.1071\/sh19079","type":"journal-article","created":{"date-parts":[[2019,10,30]],"date-time":"2019-10-30T17:50:27Z","timestamp":1572457827000},"page":"598-599","source":"Crossref","is-referenced-by-count":3,"title":["Symptomatic secondary syphilis: empirical antimicrobial treatment or await microbiology?"],"prefix":"10.1071","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0955-6307","authenticated-orcid":true,"given":"Daniel","family":"Richardson","sequence":"first","affiliation":[{"name":"ABrighton & Sussex University NHS trust, Brighton, Department of Sexual Health, Brighton BN2 5BE, UK."},{"name":"BBrighton & Sussex Medical School, Brighton BN2 5BE, UK."},{"name":"CPresent address: Western Sydney Sexual Health Centre, 162 Marsden Street, Parramatta, NSW 2150, Australia."},{"name":"DCorresponding author. Email: daniel.richardson2@health.nsw.gov.au"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Colin","family":"Fitzpatrick","sequence":"additional","affiliation":[{"name":"ABrighton & Sussex University NHS trust, Brighton, Department of Sexual Health, Brighton BN2 5BE, UK."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fionnuala","family":"Finnerty","sequence":"additional","affiliation":[{"name":"ABrighton & Sussex University NHS trust, Brighton, Department of Sexual Health, Brighton BN2 5BE, UK."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Debbie","family":"Williams","sequence":"additional","affiliation":[{"name":"ABrighton & Sussex University NHS trust, Brighton, Department of Sexual Health, Brighton BN2 5BE, UK."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"67","published-online":{"date-parts":[[2019,10,31]]},"reference":[{"key":"2025102615524052700_R1","doi-asserted-by":"publisher","DOI":"10.1017\/S0950268819000281","article-title":"The resurgence of syphilis in high-income countries in the 2000s: a focus on Europe.","volume":"147","author":"Spiteri","year":"2019","journal-title":"Epidemiol Infect"},{"key":"2025102615524052700_R2","doi-asserted-by":"publisher","first-page":"S130","DOI":"10.1086\/511426","article-title":"Current controversies in the management of adult syphilis.","volume":"44","author":"Stoner","year":"2007","journal-title":"Clin Infect Dis"},{"key":"2025102615524052700_R3","doi-asserted-by":"publisher","first-page":"697","DOI":"10.1177\/0956462415595323","article-title":"A significant increase in cases of infectious syphilis in men who have sex with men (MSM) since November 2013.","volume":"27","author":"Pinto-Sander","year":"2016","journal-title":"Int J STD AIDS"},{"key":"2025102615524052700_R4","doi-asserted-by":"publisher","first-page":"501","DOI":"10.1136\/sextrans-2018-053749","article-title":"The changing face of the syphilis epidemic in men who have sex with men.","volume":"94","author":"Taine","year":"2018","journal-title":"Sex Transm Infect"},{"key":"2025102615524052700_R5","doi-asserted-by":"crossref","first-page":"609","DOI":"10.1186\/s12879-018-3528-4","article-title":"Stably high azithromycin resistance and decreasing ceftriaxone susceptibility in Neiserria gonorrhoea in 25 European countries, 2016.","volume":"18","author":"Day","year":"2018","journal-title":"BMC Infect Dis"},{"issue":"8","key":"2025102615524052700_R6","doi-asserted-by":"publisher","first-page":"513","DOI":"10.1097\/OLQ.0000000000001009","article-title":"Men who have sex with men with Mycoplasma genitalium positive non gonococcal urethritis are more likely to have macrolide resistant strains than men with only female partners: a prospective study.","volume":"46","author":"McIver","year":"2019","journal-title":"Sex Transm Dis"},{"key":"2025102615524052700_R7","doi-asserted-by":"publisher","first-page":"154","DOI":"10.1056\/NEJMoa040216","article-title":"Macrolide resistance in Treponema pallidum in the United States and Ireland.","volume":"351","author":"Lukehart","year":"2004","journal-title":"N Engl J Med"}],"container-title":["Sexual Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/connectsci.au\/sh\/article-pdf\/16\/6\/598\/799267\/sh19079.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/connectsci.au\/sh\/article-pdf\/16\/6\/598\/799267\/sh19079.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,26]],"date-time":"2025-10-26T19:52:49Z","timestamp":1761508369000},"score":1,"resource":{"primary":{"URL":"https:\/\/connectsci.au\/sh\/article\/16\/6\/598\/101987\/Symptomatic-secondary-syphilis-empirical"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,10,31]]},"references-count":7,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2019,11,26]]}},"URL":"https:\/\/doi.org\/10.1071\/sh19079","relation":{},"ISSN":["1448-5028","1449-8987"],"issn-type":[{"value":"1448-5028","type":"print"},{"value":"1449-8987","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,10,31]]}}}