{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T10:22:42Z","timestamp":1792664562189,"version":"4.5.0"},"reference-count":21,"publisher":"BMJ","issue":"3","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Sex Transm Infect"],"published-print":{"date-parts":[[2022,5]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>Intramuscular benzathine penicillin G is not available in certain countries. In a previous report, 3 g\/day amoxicillin with probenecid was shown to be effective in treating syphilis in patients with HIV; however, 7.3% of patients changed their therapy owing to adverse events. The objective of this study was to assess the clinical efficacy and tolerability of 1.5 g\/day amoxicillin without probenecid for the treatment of syphilis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The routine clinical records of patients diagnosed with syphilis and treated with 1.5 g\/day amoxicillin at a tertiary care hospital between 2006 and 2018 were retrospectively analysed. Syphilis was diagnosed if serum rapid plasma reagin (RPR) titres were \u22658\u2009RU and the <jats:italic>Treponema pallidum<\/jats:italic> latex-agglutination test was positive. Serological cure was defined as a \u2265fourfold decrease in the RPR titre within 12 months in symptomatic early syphilis and within 24 months in latent syphilis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Overall, 138 patients (112 with HIV) were analysed. The percentages of primary, secondary, early latent, late latent and latent syphilis of unknown duration were 8.0%, 50.0%, 25.4%, 5.8% and 10.9%, respectively. The median treatment duration was 4.5 weeks (IQR 4\u20138 weeks), which was not related to the stage of syphilis. Two patients (1.5%) changed treatment due to skin rash. The rate of serological cure was 94.9% (131\/138; 95% CI 89.8% to 97.9%) overall; 93.8% (105\/112; 95%\u2009CI 87.5% to 97.5%) in patients with HIV and 100% (26\/26; 95%\u2009CI 86.8% to 100%) in patients without HIV. Treatment duration was not related to the treatment efficacy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The regimen of 1.5 g\/day amoxicillin without probenecid is highly effective with a low switch rate in patients with and without HIV.<\/jats:p><\/jats:sec>","DOI":"10.1136\/sextrans-2020-054823","type":"journal-article","created":{"date-parts":[[2021,3,29]],"date-time":"2021-03-29T17:29:55Z","timestamp":1617038995000},"page":"173-177","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":16,"title":["Clinical efficacy and tolerability of 1.5 g\/day oral amoxicillin therapy without probenecid for the treatment of syphilis"],"prefix":"10.1136","volume":"98","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1677-3369","authenticated-orcid":false,"given":"Kazuhiko","family":"Ikeuchi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazuaki","family":"Fukushima","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masaru","family":"Tanaka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keishiro","family":"Yajima","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akifumi","family":"Imamura","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2021,3,29]]},"reference":[{"key":"2022100410401120000_98.3.173.1","doi-asserted-by":"publisher","DOI":"10.2471\/BLT.18.228486"},{"key":"2022100410401120000_98.3.173.2","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 - United States, 2013-2017","volume":"68","author":"Kidd","year":"2019","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"2022100410401120000_98.3.173.3","unstructured":"Division of STD Prevention Nxational Center for HIV\/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention. Syphilis - Sexually Transmitted Disease Surveillance 2018, 2019. Available: https:\/\/www.cdc.gov\/std\/stats18\/Syphilis.htm"},{"key":"2022100410401120000_98.3.173.4","doi-asserted-by":"crossref","first-page":"323","DOI":"10.1111\/hiv.12307","article-title":"High frequency of neurosyphilis in HIV-positive patients diagnosed with early syphilis","volume":"17","author":"Firlag-Burkacka","year":"2016","journal-title":"HIV Med"},{"key":"2022100410401120000_98.3.173.5","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.rr6404a1"},{"key":"2022100410401120000_98.3.173.6","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/civ270"},{"key":"2022100410401120000_98.3.173.7","doi-asserted-by":"publisher","DOI":"10.1097\/00007435-198307000-00011"},{"key":"2022100410401120000_98.3.173.8","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.11.1.132"},{"key":"2022100410401120000_98.3.173.9","first-page":"694","article-title":"[Guideline for STD]","volume":"61 Suppl 2","author":"Matsumoto","year":"2003","journal-title":"Nihon Rinsho"},{"key":"2022100410401120000_98.3.173.10","doi-asserted-by":"publisher","DOI":"10.1038\/bmt.2012.244"},{"key":"2022100410401120000_98.3.173.11","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199707313370504"},{"key":"2022100410401120000_98.3.173.12","first-page":"1087","article-title":"Benzathine penicillin G in the treatment of syphilis","volume":"15","author":"Smith","year":"1956","journal-title":"Bull World Health Organ"},{"key":"2022100410401120000_98.3.173.13","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2014.13259"},{"key":"2022100410401120000_98.3.173.14","doi-asserted-by":"publisher","DOI":"10.1177\/0956462415624059"},{"key":"2022100410401120000_98.3.173.15","first-page":"6","article-title":"The nature of penicillin, mode of action, and principles of penicillin therapy","volume":"47 Suppl","author":"O","year":"1972","journal-title":"Bull World Health Organ"},{"key":"2022100410401120000_98.3.173.16","doi-asserted-by":"crossref","DOI":"10.1128\/mBio.01153-18","article-title":"Long-Term In Vitro Culture of the Syphilis Spirochete Treponema pallidum subsp. pallidum","volume":"9","author":"Edmondson","year":"2018","journal-title":"mBio"},{"key":"2022100410401120000_98.3.173.17","doi-asserted-by":"crossref","DOI":"10.1128\/AAC.00979-20","article-title":"In Vitro Susceptibility of Treponema pallidum subsp. pallidum to Doxycycline","volume":"64","author":"Edmondson","year":"2020","journal-title":"Antimicrob Agents Chemother"},{"key":"2022100410401120000_98.3.173.18","unstructured":"Kiyota H , Ishiji T , Kishimoto T . Guidelines on the diagnosis and treatment of sexually transmitted diseases. 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