{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T14:15:06Z","timestamp":1792764906691,"version":"4.5.0"},"reference-count":102,"publisher":"Oxford University Press (OUP)","issue":"Supplement_2","license":[{"start":{"date-parts":[[2022,4,13]],"date-time":"2022-04-13T00:00:00Z","timestamp":1649808000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"DOI":"10.13039\/100000002","name":"NIH","doi-asserted-by":"publisher","award":["K23AI125715"],"award-info":[{"award-number":["K23AI125715"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,4,13]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>A panel of experts generated 5 \u201ckey questions\u201d in the management of adult syphilis. A systematic literature review was conducted and tables of evidence were constructed to answer these questions. Available data suggest no clinical benefit to &amp;gt;1 dose of benzathine penicillin G for early syphilis in human immunodeficiency virus (HIV)\u2013infected patients. While penicillin remains the drug of choice to treat syphilis, doxycycline to treat early and late latent syphilis is an acceptable alternate option if penicillin cannot be used. There are very limited data regarding the impact of additional antibiotic doses on serologic responses in serofast patients and no data on the impact of additional antibiotic courses on long-term clinical outcomes. In patients with isolated ocular or otic signs and symptoms, reactive syphilis serologic results, and confirmed ocular\/otic abnormalities at examination, a diagnostic cerebrospinal fluid (CSF) examination is not necessary, because up to 40% and 90% of patients, respectively, would have no CSF abnormalities. Based on the results of 2 studies, repeated CSF examinations are not necessary for HIV-uninfected patients or HIV-infected patients on antiretroviral therapy who exhibit appropriate serologic and clinical responses after treatment for neurosyphilis. Finally, several important gaps were identified and should be a priority for future research.<\/jats:p>","DOI":"10.1093\/cid\/ciac060","type":"journal-article","created":{"date-parts":[[2022,2,17]],"date-time":"2022-02-17T12:08:51Z","timestamp":1645099731000},"page":"S127-S133","source":"Crossref","is-referenced-by-count":36,"title":["Management of Adult Syphilis: Key Questions to Inform the 2021 Centers for Disease Control and Prevention Sexually Transmitted Infections Treatment Guidelines"],"prefix":"10.1093","volume":"74","author":[{"given":"Susan","family":"Tuddenham","sequence":"first","affiliation":[{"name":"Johns Hopkins University School of Medicine, Baltimore, Maryland, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khalil G","family":"Ghanem","sequence":"additional","affiliation":[{"name":"Johns Hopkins University School of Medicine, Baltimore, Maryland, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2022,4,13]]},"reference":[{"key":"2022041312505204600_CIT0001","author":"Centers for Disease Control."},{"key":"2022041312505204600_CIT0002","doi-asserted-by":"crossref","first-page":"144","DOI":"10.15585\/mmwr.mm6806a4","article-title":"Increased methamphetamine, injection drug, and heroin use among women and heterosexual men with primary and secondary syphilis\u2014United States, 2013-2017","volume":"68","author":"Kidd","year":"2019","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"2022041312505204600_CIT0003","doi-asserted-by":"crossref","first-page":"1241","DOI":"10.15585\/mmwr.mm6444a3","article-title":"Increase in incidence of congenital syphilis\u2014United States, 2012-2014","volume":"64","author":"Bowen","year":"2015","journal-title":"MMWR Morb Mortal Wkly 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