In a multicenter, open, randomized, prospective, comparative study, 28 patients with primary (n = 9) or secondary (n = 19)
syphilis were treated with either
ceftriaxone or
penicillin G. 14 patients received
ceftriaxone 4 x 1 g i.m. every 2 days. 14 other patients were treated with
penicillin G 1 million IU i.m. daily for 15 days (standard
therapy of primary and
secondary syphilis). To avoid Herxheimer reaction we applied
prednisolone 50-100 mg i.m. before specific treatment. Diagnosis was confirmed by clinical symptoms, dark-field microscopy and serological tests (VDRL titer, TPHA test and 19s-
IgM-FTA-abs test or SPHA test). Follow-up examinations during
therapy were repeated on days 2, 4, 6 (dark-field microscopy, physical examination) and day 14 (VDRL titer). To evaluate therapeutic efficacy, serological controls were repeated 1, 2, 3, 6 and 12 months after
therapy (VDRL, SPHA). In all patients, a marked decline (minimum 2-dilution decrease) in VDRL titer and resolution of clinical symptoms were noted. An adverse reaction was seen in 1 patient of the clemizol-
penicillin G group (allergic
penicillin exanthema). There were no adverse reactions to
ceftriaxone. Summing up, there was no detectable difference in clinical and serological response to
syphilis treatment either with
ceftriaxone or
penicillin G.
Ceftriaxone, thus can be regarded as an equivalent alternative to
penicillin G in the treatment of primary and
secondary syphilis.