AI Article Synopsis
- Benzathine penicillin G (BPG) is the standard treatment for early syphilis, but recent shortages have prompted the need for alternative therapies.
- A study in France assessed genetic resistance of the syphilis-causing bacteria, Treponema pallidum, to macrolides and doxycycline using swabs from 146 patients.
- Results showed a high level of macrolide resistance (85% of samples), while no resistance to doxycycline was found, suggesting doxycycline is a viable substitute for BPG in treating early syphilis.
Article Abstract
Benzathine penicillin G (BPG) is the reference treatment for early syphilis, but shortages have recently been reported, highlighting a need for the validation of alternative treatments. The aim of this study was to evaluate the genomic resistance of Treponema pallidum subspecies pallidum (TPA) to macrolides and doxycycline in France. Swabs from genital, anal, oral and cutaneous lesions were obtained from 146 patients with early syphilis in France. They were screened for mutations conferring resistance to macrolides and doxycycline by nested PCR and sequencing. Resistance to macrolides was detected in 85% of the isolates, but no point mutations conferring doxycycline resistance were detected. These findings confirm that, in France, resistance to macrolides is widespread. Moreover, we confirmed the absence of genomic resistance to doxycycline in the TPA strains. Therefore, doxycycline could be safely recommended as an alternative to BPG for the treatment of early syphilis.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9199928 | PMC |
| http://dx.doi.org/10.2340/00015555-3589 | DOI Listing |
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