{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T21:23:00Z","timestamp":1787865780558,"version":"build-2784847793"},"reference-count":10,"publisher":"Oxford University Press (OUP)","issue":"10","license":[{"start":{"date-parts":[[2025,8,7]],"date-time":"2025-08-07T00:00:00Z","timestamp":1754524800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,10,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>Cefixime is a promising oral treatment alternative for early syphilis but only very limited efficacy data exist. We evaluated the efficacy and safety of cefixime for the treatment of early syphilis.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>A randomized controlled, open label trial in patients with confirmed early syphilis who were randomized to treatment with cefixime 400\u2005mg orally twice a day for 14 consecutive days or to a single dose of benzathine penicillin G (BPG) 2.4 MIU intramuscular. The outcome was a 4-fold or more (\u22652 dilution steps) decrease in Venereal Disease Research Laboratory test (VDRL) titre from baseline to 3\u2005months (primary outcome) or 12\u2005months (secondary outcome) after the treatment.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Of 61 randomized patients, 58 (95.1%) completed the study (28 patients in the cefixime arm and 30 in the BPG arm). In the intention to treat analysis, the primary endpoint was achieved after 3\u2005months in 22 of 30 (73.3%) of patients in the cefixime arm and 27 of 31 (87.1%) in the BPG arm, and after 12\u2005months in 28 of 30 (93.3%) of patients in the cefixime arm and 30 of 31 (96.8%) of patients in the BPG arm. Both treatments were well tolerated and no serious adverse events or adverse events with severe intensity were reported.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>The results from our study are consistent with current limited knowledge and suggest that oral cefixime can be an effective and safe therapy for the treatment of early syphilis. However, additional efficacy data from larger treatment studies are imperative.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/jac\/dkaf268","type":"journal-article","created":{"date-parts":[[2025,8,12]],"date-time":"2025-08-12T19:04:02Z","timestamp":1755025442000},"page":"2654-2658","source":"Crossref","is-referenced-by-count":6,"title":["Cefixime versus benzathine penicillin G for the treatment of early syphilis\u2014a randomized, controlled open label trial"],"prefix":"10.1093","volume":"80","author":[{"given":"Tamara","family":"Klementov\u00e1","sequence":"first","affiliation":[{"name":"Dermatovenereology Department, Second Faculty of Medicine, Charles University, University Hospital Bulovka , Prague ,","place":["Czech Republic"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hana","family":"Z\u00e1kouck\u00e1","sequence":"additional","affiliation":[{"name":"National Reference Laboratory for Diagnostics of Syphilis, National Institute for Public Health , Prague ,","place":["Czech Republic"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beatrice","family":"B\u00ed\u017eov\u00e1","sequence":"additional","affiliation":[{"name":"Dermatovenereology Department, Second Faculty of Medicine, Charles University, University Hospital Bulovka , Prague ,","place":["Czech Republic"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1710-2081","authenticated-orcid":false,"given":"Magnus","family":"Unemo","sequence":"additional","affiliation":[{"name":"World Health Organization Collaborating Centre for Gonorrhoea and Other STIs, Department of Laboratory Medicine, Microbiology, Faculty of Medicine of Health, \u00d6rebro University , \u00d6rebro ,","place":["Sweden"]},{"name":"Institute for Global Health, University College London , London ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5257-205X","authenticated-orcid":false,"given":"Filip","family":"Rob","sequence":"additional","affiliation":[{"name":"Dermatovenereology Department, Second Faculty of Medicine, Charles University, University Hospital Bulovka , Prague ,","place":["Czech Republic"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,8,7]]},"reference":[{"key":"2025100314244568200_dkaf268-B1","doi-asserted-by":"publisher","first-page":"e66787","DOI":"10.7759\/cureus.66787","article-title":"Benzathine penicillin G shortage and secondary syphilis","volume":"16","author":"Snider","year":"2024","journal-title":"Cureus"},{"key":"2025100314244568200_dkaf268-B2","doi-asserted-by":"publisher","first-page":"22","DOI":"10.1007\/s11904-025-00725-4","article-title":"Expanding horizons in syphilis treatment: challenges, advances, and opportunities for alternative antibiotics","volume":"22","author":"Villarreal","year":"2025","journal-title":"Curr HIV\/AIDS Rep"},{"key":"2025100314244568200_dkaf268-B3","doi-asserted-by":"publisher","first-page":"587","DOI":"10.1128\/CMR.00010-14","article-title":"Antimicrobial resistance in Neisseria gonorrhoeae in the 21st century: past, evolution, and future","volume":"27","author":"Unemo","year":"2014","journal-title":"Clin Microbiol Rev"},{"key":"2025100314244568200_dkaf268-B4","doi-asserted-by":"publisher","first-page":"907","DOI":"10.1093\/cid\/ciab187","article-title":"Clinical efficacy of cefixime for the treatment of early syphilis","volume":"73","author":"Stafylis","year":"2021","journal-title":"Clin Infect Dis"},{"key":"2025100314244568200_dkaf268-B5","doi-asserted-by":"publisher","first-page":"1009","DOI":"10.1186\/s13063-020-04885-z","article-title":"Clinical trial protocol to evaluate the efficacy of cefixime in the treatment of early syphilis","volume":"21","author":"Mehta","year":"2020","journal-title":"Trials"},{"key":"2025100314244568200_dkaf268-B6","author":"Wilson"},{"key":"2025100314244568200_dkaf268-B7","doi-asserted-by":"publisher","first-page":"405","DOI":"10.1186\/s12879-020-04980-1","article-title":"Phase II trial evaluating the clinical efficacy of cefixime for treatment of active syphilis in non-pregnant women in Brazil (CeBra)","volume":"20","author":"Taylor","year":"2020","journal-title":"BMC Infect Dis"},{"key":"2025100314244568200_dkaf268-B8","doi-asserted-by":"publisher","first-page":"574","DOI":"10.1111\/jdv.16946","article-title":"2020 European guideline on the management of syphilis","volume":"35","author":"Janier","year":"2021","journal-title":"J Eur Acad Dermatol Venereol"},{"key":"2025100314244568200_dkaf268-B9","doi-asserted-by":"publisher","first-page":"131","DOI":"10.1097\/OLQ.0000000000001742","article-title":"Effectiveness of cefixime for the treatment of Neisseria gonorrhoeae infection at 3 anatomic sites: a systematic review and meta-analysis","volume":"50","author":"Yang","year":"2023","journal-title":"Sex Transm Dis"},{"key":"2025100314244568200_dkaf268-B10","doi-asserted-by":"publisher","first-page":"211","DOI":"10.1016\/j.cmi.2023.11.006","article-title":"Single-dose cefixime 800\u2005mg plus doxycycline 100\u2005mg twice a day for 7\u2005days compared with single-dose ceftriaxone 1\u2005g plus single-dose azithromycin 2\u2005g for treatment of urogenital, rectal, and pharyngeal gonorrhoea: a randomised clinical trial","volume":"30","author":"B\u00ed\u017eov\u00e1","year":"2024","journal-title":"Clin Microbiol Infect"}],"container-title":["Journal of Antimicrobial 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