{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T01:04:14Z","timestamp":1793754254630,"version":"4.6.1"},"reference-count":13,"publisher":"BMJ","issue":"5","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Sex Transm Infect"],"accepted":{"date-parts":[[2025,11,13]]},"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To determine whether intensifying therapy with three weekly doses of benzathine penicillin G (BPG) improves maternal serological response in early syphilis during pregnancy compared with the standard single dose.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this randomised, non-blinded, single-centre study, 23 pregnant women with secondary or early latent syphilis and no previous history of the disease were enrolled. Participants were assigned to receive either a single intramuscular 2.4 million International Units (MIU) dose of BPG (n=12) or 3\u2009weekly intramuscular doses of 2.4 MIU (n=11). Venereal Disease Research Laboratory (VDRL) titres were measured at baseline, delivery and 2\u2009months postpartum. Serological change (\u0394VDRL) was defined as the number of twofold dilution decreases between baseline and follow-up. Neonates underwent clinical and serological evaluation at birth and were followed up to 6\u2009months.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Median gestational age at treatment initiation was 16.5 weeks in the single-dose group and 19 weeks in the three-dose group. Baseline median VDRL titres were 1:16 and 1:8, respectively. By delivery, 60.9% of women showed no change in VDRL titre, and only a minority achieved a \u22652-dilution decrease. Two months postpartum, further declines were observed but most women still did not reach a fourfold decline. There were no significant differences in VDRL titres between groups at delivery (median 1:8 in both, p=0.66) or 2\u2009months postpartum (median 1:4 in both, p=1.0). \u0394VDRL was not associated with gestational age at treatment or treatment-to-delivery interval. All neonates were clinically healthy, had VDRL titres equal to or lower than their mothers at delivery and achieved complete seroreversion of both treponemal and non-treponemal tests by 6\u2009months.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This is the first randomised study evaluating intensified therapy for early syphilis in pregnancy. Three weekly BPG doses did not improve maternal serological response or neonatal outcomes compared with a single dose. These findings support current recommendations for single-dose therapy in early syphilis during pregnancy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/sextrans-2025-056744","type":"journal-article","created":{"date-parts":[[2025,11,28]],"date-time":"2025-11-28T12:41:28Z","timestamp":1764333688000},"page":"305-309","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Single versus three doses of benzathine penicillin G for early syphilis in pregnancy: no added benefit in serological response or neonatal outcomes"],"prefix":"10.1136","volume":"102","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7481-2621","authenticated-orcid":false,"given":"Konrad","family":"Kamini\u00f3w","sequence":"first","affiliation":[{"name":"Clinical Department of Dermatology, Medical University of Silesia, Katowice, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Agnieszka","family":"Kotlarz","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Obstetrics, Jagiellonian University Medical College, Krak\u00f3w, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martyna","family":"Kio\u0142basa","sequence":"additional","affiliation":[{"name":"Clinical Department of Dermatology, Medical University of Silesia, Katowice, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7241-9685","authenticated-orcid":false,"given":"Maciej","family":"Pastuszczak","sequence":"additional","affiliation":[{"name":"Clinical Department of Dermatology, Medical University of Silesia, Katowice, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2025,11,28]]},"reference":[{"key":"2026071602100841000_102.5.305.1","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1007\/s40471-018-0138-z","article-title":"An Update on the Global Epidemiology of Syphilis","volume":"5","author":"Kojima","year":"2018","journal-title":"Curr Epidemiol Rep"},{"key":"2026071602100841000_102.5.305.2","doi-asserted-by":"crossref","DOI":"10.3390\/jcm14155308","article-title":"The Epidemiology of Syphilis Worldwide in the Last Decade","volume":"14","author":"Rosset","year":"2025","journal-title":"J Clin Med"},{"key":"2026071602100841000_102.5.305.3","doi-asserted-by":"crossref","DOI":"10.1155\/2012\/430585","article-title":"Syphilis Infection during pregnancy: fetal risks and clinical management","volume":"2012","author":"De Santis","year":"2012","journal-title":"Infect Dis Obstet Gynecol"},{"key":"2026071602100841000_102.5.305.4","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciu920"},{"key":"2026071602100841000_102.5.305.5","doi-asserted-by":"publisher","DOI":"10.1155\/S1064744997000070"},{"key":"2026071602100841000_102.5.305.6","doi-asserted-by":"crossref","first-page":"977","DOI":"10.1016\/j.jogc.2020.01.023","article-title":"Sexually Transmitted and Blood-Borne Infections in Pregnant Women and Adverse Pregnancy Outcomes","volume":"42","author":"D\u2019Aiuto","year":"2020","journal-title":"J Obstet Gynaecol Can"},{"key":"2026071602100841000_102.5.305.7","doi-asserted-by":"crossref","first-page":"427","DOI":"10.1002\/ijgo.14131","article-title":"Seroreduction of syphilis non-treponemal titers during pregnancy for women with and without HIV co-infection","volume":"159","author":"Webster","year":"2022","journal-title":"Int J Gynaecol Obstet"},{"key":"2026071602100841000_102.5.305.8","doi-asserted-by":"crossref","first-page":"1563","DOI":"10.1097\/CM9.0000000000002115","article-title":"Associations of toluidine red unheated serum test response to the treatment of syphilis in pregnancy and congenital syphilis: a 10-year real-world study","volume":"135","author":"Wei","year":"2022","journal-title":"Chin Med J (Engl)"},{"key":"2026071602100841000_102.5.305.9","doi-asserted-by":"crossref","first-page":"100957","DOI":"10.1016\/j.ajogmf.2023.100957","article-title":"Risk factors and adverse outcomes associated with syphilis infection during pregnancy","volume":"5","author":"Gulersen","year":"2023","journal-title":"Am J Obstet Gynecol MFM"},{"key":"2026071602100841000_102.5.305.10","doi-asserted-by":"crossref","first-page":"560","DOI":"10.1093\/infdis\/jiaf193","article-title":"Serological Responses and Pregnancy Outcomes in Women With Serofast Syphilis: Efficacy of Retreatment in a Prospective Nested Case-Control Study","volume":"232","author":"Yan","year":"2025","journal-title":"J Infect Dis"},{"key":"2026071602100841000_102.5.305.11","unstructured":"Centers for Disease Control and Prevention . Sexually transmitted diseases treatment guidelines, 2021. Atlanta (GA): US Department of Health and Human Services, 2021."},{"key":"2026071602100841000_102.5.305.12","doi-asserted-by":"crossref","DOI":"10.3390\/jcm13144031","article-title":"Lack of Serological Response by Delivery to Syphilis Treatment Does Not Impact Pregnancy Outcomes","volume":"13","author":"Kamini\u00f3w","year":"2024","journal-title":"J Clin Med"},{"key":"2026071602100841000_102.5.305.13","unstructured":"Public Health Agency of Canada . Syphilis guide: treatment and follow-up. Ottawa Government of Canada; 2023. Available: https:\/\/www.canada.ca\/en\/public-health\/services\/infectious-diseases\/sexual-health-sexually-transmitted-infections\/canadian-guidelines\/syphilis\/treatment-follow-up.html"}],"container-title":["Sexually Transmitted Infections"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/sextrans-2025-056744","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T09:10:35Z","timestamp":1784193035000},"score":1,"resource":{"primary":{"URL":"https:\/\/sti.bmj.com\/lookup\/doi\/10.1136\/sextrans-2025-056744"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,28]]},"references-count":13,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2026,7,16]]},"published-print":{"date-parts":[[2026,8]]}},"alternative-id":["10.1136\/sextrans-2025-056744"],"URL":"https:\/\/doi.org\/10.1136\/sextrans-2025-056744","relation":{},"ISSN":["1368-4973","1472-3263"],"issn-type":[{"value":"1368-4973","type":"print"},{"value":"1472-3263","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,28]]}}}