{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T09:58:09Z","timestamp":1785491889225,"version":"3.56.0"},"reference-count":37,"publisher":"Oxford University Press (OUP)","issue":"7","license":[{"start":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T00:00:00Z","timestamp":1783900800000},"content-version":"vor","delay-in-days":12,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,7,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Neurosyphilis, ocular syphilis, and otosyphilis occur more frequently among people with HIV-1 and are associated with higher morbidity and treatment failure. Intravenous penicillin G remains the standard therapy but requires hospitalization or prolonged intravenous access, creating barriers that are amplified in resource-limited settings facing recurrent penicillin shortages. Ceftriaxone is a potential alternative; however, comparative data in people with HIV are limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a multicenter retrospective cohort study of adults with HIV at 5 public hospitals and 2 outpatient HIV clinics in Mexico (2015\u20132024). Participants had confirmed neurosyphilis, ocular syphilis, or otosyphilis. Participants received intravenous penicillin G (18\u201324\u2005million IU\/day) or ceftriaxone (1\u20132\u2005g\/day) for 10\u201314 days. The primary outcome was early serological response (ESR), defined as a \u22654-fold nontreponemal titer decline or seroreversion at 6 months. We performed 1:1 propensity score matching (39 pairs, n = 78), followed by logistic regression in the matched cohort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of 143 participants, 104 (73%) received intravenous penicillin G and 39 (27%) ceftriaxone. In the matched cohort, ESR occurred in 74.4% of penicillin-treated participants and 71.8% of ceftriaxone-treated participants (odds ratio 0.88, 95% confidence interval .32\u20132.40; P = .80). The results were consistent across all prespecified sensitivity analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In this multicenter cohort of people with HIV diagnosed with neurosyphilis, ocular syphilis, or otosyphilis, ceftriaxone showed comparable ESR to intravenous penicillin G. These findings support ceftriaxone as a reasonable alternative when standard therapy is limited by penicillin shortages, limited inpatient capacity, or financial constraints.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ofid\/ofag387","type":"journal-article","created":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T17:43:23Z","timestamp":1783964603000},"source":"Crossref","is-referenced-by-count":0,"title":["Penicillin or Ceftriaxone for Neurosyphilis in People With HIV: A Retrospective, Propensity Score\u2013Matched Multicenter Study in Mexico"],"prefix":"10.1093","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2158-831X","authenticated-orcid":false,"given":"Rodrigo","family":"Ville Benavides","sequence":"first","affiliation":[{"name":"Departamento de Infectolog\u00eda, Instituto Nacional de Ciencias M\u00e9dicas y Nutrici\u00f3n Salvador Zubir\u00e1n , Mexico City ,","place":["Mexico"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-9735-3892","authenticated-orcid":false,"given":"H\u00e9ctor","family":"Rivera-Villegas","sequence":"additional","affiliation":[{"name":"Departamento de Infectolog\u00eda, Instituto Nacional de Ciencias M\u00e9dicas y Nutrici\u00f3n Salvador Zubir\u00e1n , Mexico City ,","place":["Mexico"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-1030-6179","authenticated-orcid":false,"given":"Obed","family":"Ocampo-Valdez","sequence":"additional","affiliation":[{"name":"Departamento de Infectolog\u00eda, Instituto Nacional de Ciencias M\u00e9dicas y Nutrici\u00f3n Salvador Zubir\u00e1n , Mexico City 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Alicia","family":"Gonz\u00e1lez-Hern\u00e1ndez","sequence":"additional","affiliation":[{"name":"Unidad de VIH, Hospital Civil de Guadalajara \u201cFray Antonio Alcalde,\u201d Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara , Guadalajara ,","place":["Mexico"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0505-6340","authenticated-orcid":false,"given":"Pedro","family":"Mart\u00ednez-Ayala","sequence":"additional","affiliation":[{"name":"Unidad de VIH, Hospital Civil de Guadalajara \u201cFray Antonio Alcalde,\u201d Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara , Guadalajara ,","place":["Mexico"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-1827-3283","authenticated-orcid":false,"given":"Andrea","family":"C\u00e1rdenas-Ortega","sequence":"additional","affiliation":[{"name":"Cl\u00ednica de Inmunocompromiso por Enfermedades Infecciosas (CIENI), Instituto Nacional de Enfermedades Respiratorias Ismael Cos\u00edo Villegas , Mexico City ,","place":["Mexico"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3809-9651","authenticated-orcid":false,"given":"Paulina","family":"Carre\u00f1o-P\u00e9rez","sequence":"additional","affiliation":[{"name":"Cl\u00ednica de Inmunocompromiso por Enfermedades Infecciosas (CIENI), Instituto Nacional de Enfermedades Respiratorias Ismael Cos\u00edo Villegas , Mexico City ,","place":["Mexico"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jezer","family":"Lezama-Mora","sequence":"additional","affiliation":[{"name":"Cl\u00ednica de S\u00edfilis, Cl\u00ednica Especializada Condesa Cuauht\u00e9moc , Mexico City ,","place":["Mexico"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8664-9879","authenticated-orcid":false,"given":"Juan Carlos","family":"Rodr\u00edguez-Aldama","sequence":"additional","affiliation":[{"name":"Departamento de Infectolog\u00eda, Cl\u00ednica Especializada Condesa Iztapalapa , Mexico City ,","place":["Mexico"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3839-1567","authenticated-orcid":false,"given":"Edgar","family":"P\u00e9rez-Barrag\u00e1n","sequence":"additional","affiliation":[{"name":"Departamento de Infectolog\u00eda, Cl\u00ednica Especializada Condesa Iztapalapa , Mexico City ,","place":["Mexico"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8873-8573","authenticated-orcid":false,"given":"Pamela","family":"Alatorre-Fern\u00e1ndez","sequence":"additional","affiliation":[{"name":"Departamento de Infectolog\u00eda, Instituto Nacional de Cancerolog\u00eda , Mexico City 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