Efficacy of minocycline in the treatment of early syphilis

2021 ◽  
pp. 095646242098469
Author(s):  
Haoqing Wu ◽  
Manli Qi ◽  
Huiping Wang ◽  
Quanzhong Liu ◽  
Yuanjun Liu
Keyword(s):  
Treatment Group ◽  
Alternative Treatment ◽  
Treponema Pallidum ◽  
Benzathine Penicillin ◽  
Cure Rate ◽  
Serological Tests ◽  
Factors Affecting ◽  
Early Syphilis ◽  
Minocycline Treatment

Syphilis is the third prevalent infectious disease in China, caused by the spirochete bacterium Treponema pallidum. Minocycline is a derivative of tetracycline used as an alternative treatment for syphilis, but there are few studies in this field. In this research, we compared the efficacy of benzathine penicillin and minocycline in the treatment of early syphilis patients and analyzed some of the factors affecting the efficacy of minocycline. A total of 276 eligible patients treated between January 2011 and December 2017 were retrospectively analyzed, and 158 patients received 100 mg of minocycline orally, twice daily for 28 days, while 118 patients received benzathine penicillin, 2.4 million units intramuscular injections, once a week, 1–2 times in all. All patients accepted rapid plasma regain (RPR) serological tests and followed up for 24 months to evaluate serological treatment responses. After comparison, the serological cure rate of the minocycline treatment group (85.44%) was similar to the benzathine penicillin treatment group (88.14%). Besides, patients in the minocycline treatment group with higher initial RPR titer (≥1:32) exhibited better treatment effect. In addition, during the 24-month follow-up, the serological cure rate of primary syphilis patients after minocycline treatment was significantly higher than that of secondary and early latent syphilis patients. Therefore, minocycline may be an effective alternative treatment to early syphilis when benzathine penicillin is not available.

scholarly journals Sífilis: Prevalência num Hospital de Lisboa

2016 ◽  
Vol 29 (1) ◽  
pp. 52 ◽  
Author(s):  
Leonor Lopes ◽  
Rita Ferro-Rodrigues ◽  
Samuel Llobet ◽  
Luís Lito ◽  
João Borges-Costa
Keyword(s):  
Clinical Laboratory ◽  
Transmitted Disease ◽  
Public Health Problem ◽  
Secondary Syphilis ◽  
Disease Classification ◽  
Serological Tests ◽  
Important Public Health Problem ◽  
Early Syphilis ◽  
Latent Syphilis

<p><strong>Introduction:</strong> Syphilis is a sexual and vertical transmitted disease. Its incidence is increasing in Europe, particularly, in Portugal.<br /><strong>Material and Methods:</strong> A descriptive, retrospective study was performed based on positive treponemal tests from January to December 2013, at the Santa Maria Hospital, Lisbon. In-patients and out-patients evaluated in medical appointments and at the emergency department were included. We proceeded to epidemiological characterization, disease classification and definition of risk factors.<br /><strong>Results:</strong> We obtained a sample of 580 patients, of whom 51 with no clinical data and 45 with false positive serologies were excluded. There was a predominance of male patients (75%) and a mean age of 47 years. Most (59%) had syphilis successfully treated in the past and 3.7% were in follow-up. We recorded 13 primaries syphilis, 71 cases of secondary syphilis, 40 cases of early latent syphilis, 49 unknown duration syphilis and five cases of late latent syphilis. In the early syphilis group, 42% (n = 124) were HIV-positive and, in 8% both diagnosis were done simultaneously.<br /><strong>Discussion:</strong> We emphasize the high prevalence of syphilis/HIV co-infection in patients with early syphilis, reinforcing the importance of promoting the use of preventive measures. We obtained 11% of patients with late clinical forms, which are notifiable since June 2014, in Portugal. All serological tests for the diagnosis of syphilis have limitations which emphasizes the importance of clinical-laboratory correlation.<br /><strong>Conclusion:</strong> Syphilis remains an important public health problem. It is necessary to establish education programs, screening and follow-up strategies to reduce their prevalence and to perform more efficient screening of the partners.</p>

The outcome of treatment of early syphilis with different benzathine penicillin regimens in HIV-infected and -uninfected patients

2012 ◽  
Vol 23 (9) ◽  
pp. 632-634 ◽  
Author(s):  
DE Cousins ◽  
M Taylor ◽  
V Lee
Keyword(s):  
Single Dose ◽  
Treatment Efficacy ◽  
Treatment Guidelines ◽  
Benzathine Penicillin ◽  
Loss To Follow Up ◽  
Early Syphilis ◽  
The Uk ◽  
Cure Rates ◽  
Hiv Negative

The evolution of treatment guidelines for early syphilis to single-dose benzathine penicillin regardless of HIV status has been controversial in the UK. We describe the treatment response in patients treated by current and previous regimens of benzathine penicillin for early syphilis. We found no difference in treatment efficacy between single-dose benzathine and previously recommended benzathine treatment courses in HIV co-infected patients. HIV-positive status did alter treatment efficacy as evidenced by increased serological cure rates at 12 months, although this was not statistically significant. This may be due to the loss to follow-up in HIV-negative patients. HIV-infected patients were increasingly likely to be re-infected with syphilis compared to HIV-negative patients. Our findings also justify the screening of HIV patients with syphilis serology at each routine HIV follow-up.

scholarly journals Sífilis: Prevalência num Hospital de Lisboa

2016 ◽  
Vol 29 (1) ◽  
pp. 52
Author(s):  
Leonor Lopes ◽  
Rita Ferro-Rodrigues ◽  
Samuel Llobet ◽  
Luís Lito ◽  
João Borges-Costa
Keyword(s):  
Clinical Laboratory ◽  
Transmitted Disease ◽  
Public Health Problem ◽  
Secondary Syphilis ◽  
Disease Classification ◽  
Serological Tests ◽  
Important Public Health Problem ◽  
Early Syphilis ◽  
Latent Syphilis

<p><strong>Introduction:</strong> Syphilis is a sexual and vertical transmitted disease. Its incidence is increasing in Europe, particularly, in Portugal.<br /><strong>Material and Methods:</strong> A descriptive, retrospective study was performed based on positive treponemal tests from January to December 2013, at the Santa Maria Hospital, Lisbon. In-patients and out-patients evaluated in medical appointments and at the emergency department were included. We proceeded to epidemiological characterization, disease classification and definition of risk factors.<br /><strong>Results:</strong> We obtained a sample of 580 patients, of whom 51 with no clinical data and 45 with false positive serologies were excluded. There was a predominance of male patients (75%) and a mean age of 47 years. Most (59%) had syphilis successfully treated in the past and 3.7% were in follow-up. We recorded 13 primaries syphilis, 71 cases of secondary syphilis, 40 cases of early latent syphilis, 49 unknown duration syphilis and five cases of late latent syphilis. In the early syphilis group, 42% (n = 124) were HIV-positive and, in 8% both diagnosis were done simultaneously.<br /><strong>Discussion:</strong> We emphasize the high prevalence of syphilis/HIV co-infection in patients with early syphilis, reinforcing the importance of promoting the use of preventive measures. We obtained 11% of patients with late clinical forms, which are notifiable since June 2014, in Portugal. All serological tests for the diagnosis of syphilis have limitations which emphasizes the importance of clinical-laboratory correlation.<br /><strong>Conclusion:</strong> Syphilis remains an important public health problem. It is necessary to establish education programs, screening and follow-up strategies to reduce their prevalence and to perform more efficient screening of the partners.</p>

Audit of the use of benzathine penicillin, post-treatment syphilis serology and partner notification of patients with early infectious syphilis

2006 ◽  
Vol 17 (3) ◽  
pp. 200-202 ◽  
Author(s):  
M Chauhan ◽  
B Serisha ◽  
K N Sankar ◽  
R S Pattman ◽  
M L Schmid
Keyword(s):  
Partner Notification ◽  
Post Treatment ◽  
Benzathine Penicillin ◽  
First Line ◽  
Serological Tests ◽  
Sexual Contacts ◽  
Sex With Men ◽  
One Year ◽  
Syphilis Serology

Recent increases in the incidence of early infectious syphilis have been particularly noted in men who have sex with men (MSM). Case-notes of 40 consecutive patients with infectious syphilis and follow-up data for one year were audited. Of the 40 patients, six were HIV co-infected. In all, 31 men received benzathine penicillin as first line while the remaining had other treatments. About 17 (42.5%) failed to attend for any post-treatment serological tests. Of the remainder, 17 (42.5%) attended for the first appointment and only 13 (32.5%) attended for the full one year follow-up. In all, 40 men in the study had 362 sexual contacts of which only 44 (12.2%) elected to be screened. This study illustrates the successful use of benzathine penicillin as first-line treatment, lack of patient compliance with post-treatment serological follow-up and difficulty with partner notification.

Audit of early syphilis: Teesside experience 2005–2007

2009 ◽  
Vol 20 (9) ◽  
pp. 647-649 ◽  
Author(s):  
S Tayal ◽  
M S Ahmed ◽  
U Hanif
Keyword(s):  
Oral Therapy ◽  
Venereal Disease ◽  
Partner Notification ◽  
National Standards ◽  
Reference Laboratory ◽  
Benzathine Penicillin ◽  
Treatment Rate ◽  
Early Syphilis ◽  
Retrospective Audit

A retrospective audit of all cases of early syphilis seen in genitourinary (GU) medicine clinics in Teesside was undertaken between 2005 and 2007. In all 80 patients early syphilis was identified. Data on patient sexuality, treatment, and serological follow-up and partner notification were collected and analysed. There were 48 heterosexual cases. There were 21 heterosexual males, and of the 27 females, 12 (44%) were diagnosed during antenatal care. Intramuscular injections of benzathine penicillin were used to treat 75 out of the 80 patients at the clinics. The remaining five patients received oral therapy for two weeks: four had a course of doxycycline and one received amoxicillin plus probenecid. The treatment rate of the population was 100%. In total, there were 115 contactable partners, of whom 87 (75.7%) were screened and/or treated. Successful treatment was defined as a four-fold or greater titre decrease in the Venereal Disease Reference Laboratory test within 3–6 months after treatment. Twenty-one patients were excluded when assessing this due to incomplete serological follow-up. Satisfactory titre declines occurred in 56 (94.9%) of the 59 patients. Overall, the clinics were shown to have adhered well with national standards. The rise in heterosexual and antenatal incidence is of concern.

scholarly journals Multiplex Recombinase Polymerase Amplification Assay for Simultaneous Detection of Treponema pallidum and Haemophilus ducreyi in Yaws-Like Lesions

2020 ◽  
Vol 5 (4) ◽  
pp. 157
Author(s):  
Michael Frimpong ◽  
Shirley Victoria Simpson ◽  
Hubert Senanu Ahor ◽  
Abigail Agbanyo ◽  
Solomon Gyabaah ◽  
...  
Keyword(s):  
Simultaneous Detection ◽  
Treponema Pallidum ◽  
Recombinase Polymerase Amplification ◽  
Nucleic Acid Amplification ◽  
Haemophilus Ducreyi ◽  
World Health ◽  
Clinical Samples ◽  
Successful Implementation ◽  
Serological Tests

Yaws is a skin debilitating disease caused by Treponema pallidum subspecies pertenue with most cases reported in children. World Health Organization (WHO) aims at total eradication of this disease through mass treatment of suspected cases followed by an intensive follow-up program. However, effective diagnosis is pivotal in the successful implementation of this control program. Recombinase polymerase amplification (RPA), an isothermal nucleic acid amplification technique offers a wider range of differentiation of pathogens including those isolated from chronic skin ulcers with similar characteristics such as Haemophilus ducreyi (H. ducreyi). We have developed a RPA assay for the simultaneous detection of Treponema pallidum (T. pallidum) and H. ducreyi (TPHD-RPA). The assay demonstrated no cross-reaction with other pathogens and enable detection of T. pallidum and H. ducreyi within 15 min at 42 °C. The RPA assay was validated with 49 clinical samples from individuals confirmed to have yaws by serological tests. Comparing the developed assay with commercial multiplex real-time PCR, the assay demonstrated 94% and 95% sensitivity for T. pallidum and H. ducreyi, respectively and 100% specificity. This simple novel TPHD-RPA assay enables the rapid detection of both T. pallidum and H. ducreyi in yaws-like lesions. This test could support the yaws eradication efforts by ensuring reliable diagnosis, to enable monitoring of program success and planning of follow-up interventions at the community level.

Long-Term Results of Adrenalectomy in Patients with Aldosterone-Producing Adenomas: Multivariate Analysis of Factors Affecting Unresolved Hypertension and Review of the Literature

2005 ◽  
Vol 71 (10) ◽  
pp. 864-869 ◽  
Author(s):  
Franco Lumachi ◽  
Mario Ermani ◽  
Stefano M.M. Basso ◽  
Decio Armanini ◽  
Maurizio Iacobone ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Multivariate Analysis ◽  
Predictive Power ◽  
Long Term Results ◽  
Cure Rate ◽  
Unilateral Adrenalectomy ◽  
Factors Affecting ◽  
Classification Function

The long-term surgical cure rate of patients with primary aldosteronism varies widely, and causes of persistent hypertension are not completely established. We reviewed retrospectively charts from 98 patients (range, 19–70 years old) with aldosterone-producing adenomas who underwent unilateral adrenalectomy. At a median follow-up of 81 months (range, 18–186 months), the mean blood pressure values improved in 95 out of 98 (96.9%) patients, although hypertension was cured only in 71 out of 98 (72.4%) patients. Multivariate analysis using a logistic regression model adjusted for duration of follow-up showed that only age of the patients and duration of the disease independently correlated with unresolved hypertension. The cumulative odds ratio (OR), obtained using the logistic regression function, was 5.38 (95% CI 1.78–16.22), and the OR of single variables were 1.32 (95% CI 0.36–19.83) and 4.56 (95% CI 1.41–14.78), respectively. By using discriminant analysis to derive a classification function for the prediction of unresolved hypertension, a maximum predictive power of 75 per cent was achieved. In conclusion, in patients with an aldosterone-producing adenoma undergoing surgery, the combination of age and duration of hypertension gave the best predictive power of a linear classification function and represented the main independent risk factors affecting hypertension cure rate.

Factors Affecting the Use and Consequences of Management Accounting Practices in A Transitional Economy: The Case of Vietnam

2016 ◽  
pp. 54-73 ◽  
Author(s):  
Anh Doan Ngoc Phi
Keyword(s):  
Significant Influence ◽  
Quantitative Data ◽  
Structural Equation ◽  
Qualitative Data ◽  
Management Accounting ◽  
Transitional Economy ◽  
Equation Modeling ◽  
Enterprise Performance ◽  
Factors Affecting

This study seeks to help fill an important gap in the literature by investigating factors that have facilitated the use of management accounting practices (MAPs) in Vietnam - a transitional economy. Data were collected from 220 medium-to-large enterprises. Follow-up interviews were conducted with 20 accounting heads/vice heads to obtain further information and clarification. The quantitative data collected was analyzed using both descriptive and inferential statistics (including t-tests and structural equation modeling), while the qualitative data was used to shed further light on the various relationships described by the quantitative analysis. This paper reveals that both decentralization and competition have a positive, significant influence on the use of new MAPs except for the old ones. Consequently, the use of MAPs has a positive, significant influence on enterprise performance.

STRUCTURAL AND DYNAMIC FEATURES OF EAR-LY DISABILITY DUE TO MENTAL DISEASES

2020 ◽  
pp. 62-67
Author(s):  
Shmakova O.P.
Keyword(s):  
People With Disabilities ◽  
Child And Adolescent Psychiatry ◽  
Child Psychiatrist ◽  
Childhood And Adolescence ◽  
Disabled Children ◽  
Dynamic Features ◽  
Factors Affecting ◽  
Number Of Children ◽  
Number Of Patients

Prevention of disability is one of the most significant tasks of child and adolescent psychiatry. Obtaining data on the dynamics of the number of people with disabilities and the factors affecting this indicator seems to be one of the relevant aspects. Aim: to trace the dynamics of the number of children with disabili-ties and to assess the change in the structure of early disability over the past decades. Materials and Meth-ods. A comparative analysis of two cohorts of patients was carried out: 1st - patients born in 1990-1992. (1203 patients (men - 914, 76%; women - 289, 24%)) who applied to the district neuropsychiatric dispensa-ry for outpatient care in childhood and adolescence; II - children and adolescents born in 2005 - 2018 (602 patients (male - 410, 68%; female - 192, 32%), ob-served at the time of the study by a child psychiatrist in the neuropsychiatric dispensary. Research methods: clinical and psychopathological; follow-up; statisti-cal. Results. Comparison of the number and nosologi-cal distribution of disabled children in two cohorts showed that over the 15th year there has been a shift towards an increase in the proportion of disabled children among patients observed by child and ado-lescent psychiatrists. The increase in the number of children with disabilities was due to those suffering from childhood autism and other disorders of general development. There were no statistically significant differences in the number of people with disabilities who received benefits before the age of 7, as well as differences in gender ratios among disabled people in the two cohorts. Conclusion. Early disability is a mul-tifactorial phenomenon, prevalence, dynamics, the structure of which depends not only on clinical, but also on socio-administrative realities. Children with autism require increased attention, since there has been a multiple increase in the number of patients with this diagnosis.

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