TY - JOUR
T1 - A pilot study evaluating ceftriaxone and penicillin G as treatment agents for neurosyphilis in human immunodeficieney virus-infected individuals
AU - Marra, C. M.
AU - Boutin, P.
AU - McArthur, J. C.
AU - Hurwitz, S.
AU - Simpson, G.
AU - Haslett, P. A.J.
AU - Van Der Horst, C.
AU - Nevin, T.
AU - Hook, E. W.
N1 - Funding Information:
Received 27 August 1999; revised 18 November 1999; electronically published 23 February 2000. Presented in part at the 51st meeting of the American Academy of Neurology, held in Toronto on 17–24 April 1999 (abstract P03.010). Financial support: National Institutes of Health (NIH) Adult AIDS Clinical Trials Group; NIH (NS 34235 to C. M. M. and AI 27664 to P. B.); and Hoffmann–La Roche. Informed consent was obtained from all subjects enrolled in this study, and guidelines for human experimentation of the US Department of Health and Human Services were followed in the conduct of this research. a Participating investigators and units are listed at the end of the article. Reprints or correspondence: Dr. Christina M. Marra, Harborview Medical Center, Department of Neurology, Box 359775, 325 9th Ave., Seattle, WA 98104-2499 ([email protected]).
PY - 2000
Y1 - 2000
N2 - 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)-I 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.
AB - 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)-I 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.
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U2 - 10.1086/313725
DO - 10.1086/313725
M3 - Article
C2 - 10722441
AN - SCOPUS:0034079095
SN - 1058-4838
VL - 30
SP - 540
EP - 544
JO - Clinical Infectious Diseases
JF - Clinical Infectious Diseases
IS - 3
ER -