{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T06:51:55Z","timestamp":1787899915045,"version":"build-2784847793"},"reference-count":10,"publisher":"Oxford University Press (OUP)","issue":"7","license":[{"start":{"date-parts":[[2021,3,30]],"date-time":"2021-03-30T00:00:00Z","timestamp":1617062400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,6,18]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>Penicillin-based antibiotic treatment for syphilis infection with CNS involvement (early neurosyphilis) is not always a suitable treatment option. We compared outcomes of patients diagnosed with early neurosyphilis and treated with doxycycline or procaine G penicillin.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Serological and clinical outcomes were analysed in patients diagnosed with early neurosyphilis between January 2015 and October 2019 at 56 Dean Street, a combined sexual health and HIV service based in London, UK. Acute onset of CNS, ocular and\/or otic symptomatology and a documented seroconverting syphilis serology or a &amp;gt;4-fold increase in rapid plasma reagin (\u2018RPR)\u2019 test titre within the previous 12\u2009months were criteria used to define a case. Mann\u2013Whitney U-test and \u03c72 tests were used to test distributions between baseline characteristics and outcomes according to treatment administered.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Eighty-seven patients were included: median age\u2009=\u200935\u2009years (IQR\u2009=\u200931\u201345), 98% MSM, 79% white ethnicity, 53% HIV-1 positive and 40% previously diagnosed with syphilis at any stage. They were treated exclusively with either intramuscular (IM) procaine G penicillin (71%) or oral doxycycline (18%). Patients received doxycycline treatment over a penicillin-based regimen due to IM treatment declined (31%), inability to attend for IM injections (31%) or penicillin allergy (19%). Serological response was achieved by all patients; 91% reported full symptom resolution at 30\u2009days from end of treatment. Similar rates of clinical and serological response and seroreversion were observed in the groups treated with procaine G penicillin versus doxycycline.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The clinical and serological outcomes seen with penicillin-based versus doxycycline treatments were similar. A randomized controlled trial is needed to establish the effectiveness of doxycycline in the treatment of early neurosyphilis.<\/jats:p><\/jats:sec>","DOI":"10.1093\/jac\/dkab100","type":"journal-article","created":{"date-parts":[[2021,3,12]],"date-time":"2021-03-12T20:09:59Z","timestamp":1615579799000},"page":"1916-1919","source":"Crossref","is-referenced-by-count":26,"title":["Clinical and serological outcomes in patients treated with oral doxycycline for early neurosyphilis"],"prefix":"10.1093","volume":"76","author":[{"given":"Nicol\u00f2","family":"Girometti","sequence":"first","affiliation":[{"name":"56 Dean Street, Chelsea & Westminster Hospital NHS Foundation Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammad H","family":"Junejo","sequence":"additional","affiliation":[{"name":"56 Dean Street, Chelsea & Westminster Hospital NHS Foundation Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diarmuid","family":"Nugent","sequence":"additional","affiliation":[{"name":"56 Dean Street, Chelsea & Westminster Hospital NHS Foundation Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alan","family":"McOwan","sequence":"additional","affiliation":[{"name":"56 Dean Street, Chelsea & Westminster Hospital NHS Foundation Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gary","family":"Whitlock","sequence":"additional","affiliation":[{"name":"56 Dean Street, Chelsea & Westminster Hospital NHS Foundation Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"the 56 Dean Street Collaborative 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