Journal Article

A Pilot Study Evaluating Ceftriaxone and Penicillin G as Treatment Agents for Neurosyphilis in Human Immunodeficiency Virus-Infected Individuals

C. M. Marra, P. Boutin, J. C. McArthur, S. Hurwitz, G. Simpson, J. P. A. Haslett, C. van der Horst, T. Nevin and E. W. Hook

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 30, issue 3, pages 540-544
Published in print March 2000 | ISSN: 1058-4838
Published online March 2000 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/313725
A Pilot Study Evaluating Ceftriaxone and Penicillin G as Treatment Agents for Neurosyphilis in Human Immunodeficiency Virus-Infected Individuals

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To compare intravenous (iv) ceftriaxone and penicillin G as therapy for neurosyphilis, blood and CSF were collected before and 14–26 weeks after therapy from 30 subjects infected with human immunodeficiency virus (HIV)-1 who had (1) rapid plasma reagin (RPR) test titers ≥1 : 16, (2) reactive serum treponemal tests, and (3) either reactive CSF-Venereal Disease Research Laboratory (VDRL) tests or CSF abnormalities: (a) CSF WBC values ≥20/µL or (b) CSF protein values ≥50 mg/dL. At baseline, more ceftriaxone recipients had skin symptoms and signs (6 [43%] of 14 vs. 1 [6%] of 16; P = .03), and more penicillin recipients had a history of neurosyphilis (7 [44%] of 16 vs. 1 [7%] of 14; P = .04). There was no difference in the proportion of subjects in each group whose CSF measures improved. Significantly more ceftriaxone recipients had a decline in serum RPR titers (8 [80%] of 10 vs. 2 [13%] of 15; P = .003), even after controlling for baseline RPR titer, skin symptoms and signs, or prior neurosyphilis were controlled for. Differences in the 2 groups limit comparisons between them. However, iv ceftriaxone may be an alternative to penicillin for treatment of HIV-infected patients with neurosyphilis and concomitant early syphilis.

Journal Article.  3113 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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