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    Please use this identifier to cite or link to this item: http://ir.cnu.edu.tw/handle/310902800/30914


    標題: Comparison of serological responses to single-dose azithromycin (2 g) versus benzathine penicillin G in the treatment of early syphilis in HIV-infected patients in an area of low prevalence of macrolide-resistant Treponema pallidum infection
    作者: Yang, Chia-Jui
    Tang, Hung-Jen
    Chang, Sui-Yuan
    Hsieh, Szu-Min
    Lee, Kuan-Yeh
    Lee, Yuan-Ti
    Sheng, Wang-Huei
    Yang, Shang-Ping
    Hung, Chien-Ching
    Chang, Shan-Chwen
    貢獻者: Far Eastern Mem Hosp, Dept Internal Med
    Natl Yang Ming Univ, Sch Med
    Chi Mei Med Ctr, Dept Internal Med
    Chia Nan Univ Pharm & Sci, Dept Hlth & Nutr
    Natl Taiwan Univ, Coll Med, Dept Clin Lab Sci & Med Biotechnol
    Natl Taiwan Univ Hosp, Dept Lab Med
    Natl Taiwan Univ, Coll Med
    Natl Taiwan Univ Hosp, Dept Internal Med
    Natl Taiwan Univ Hosp, Dept Internal Med, Hsin Chu Branch
    Chung Shan Med Univ, Sch Med
    Chung Shan Med Univ Hosp, Dept Internal Med
    Natl Taiwan Univ Hosp, Ctr Infect Control
    關鍵字: ribosomal-rna a2058g
    united-states
    molecular subtypes
    secondary syphilis
    multicenter
    taiwan
    surveillance
    coinfection
    mutation
    gene
    日期: 2016-03
    上傳時間: 2018-01-18 11:37:50 (UTC+8)
    出版者: Oxford Univ Press
    摘要: Effectiveness of single-dose azithromycin (2 g) in the treatment of early syphilis among HIV-infected patients has rarely been evaluated in the era of combination ART. Consecutive HIV-infected patients with early syphilis, who received 2 g single-dose azithromycin or 2.4 MU benzathine penicillin G, between 2007 and 2014, were prospectively observed. Genotypic resistance to macrolides was determined in Treponema pallidum isolates identified from clinical specimens using PCR assays. Rapid plasma reagin (RPR) titres were determined at baseline and every 3 months after treatment. Primary outcome was a decline of RPR titre by a parts per thousand yen4-fold at 12 months after treatment. During the study period, 162 HIV-infected patients with early syphilis received benzathine penicillin G and 237 patients received azithromycin. At 12 months follow-up, the serological response rate for penicillin and azithromycin groups was 61.1% and 56.5% (PaEuroS=aEuroS0.41), respectively; respective response rate was 61.1% and 65.9% (PaEuroS=aEuroS0.49) if we only included patients infected with T. pallidum not harbouring macrolide resistance in the azithromycin group. In multivariate analysis, RPR titres a parts per thousand yen1:32 (OR 2.56; 95% CI 1.55-4.21) and prior syphilis (OR 0.54; 95% CI 0.35-0.81) were predictors of serological response. Most common adverse effects of azithromycin included diarrhoea (52.7%), nausea (22.4%), abdominal pain (18.6%), bloating (17.7%) and lassitude/somnolence (27.4%). In the setting of a low prevalence of macrolide-resistant T. pallidum, 2 g single-dose azithromycin achieved a similar serological response to benzathine penicillin G in HIV-infected patients with early syphilis. Major adverse effects of azithromycin were gastrointestinal symptoms and lassitude/somnolence.
    關聯: Journal of Antimicrobial Chemotherapy, v.71 n.3, pp.775-782
    Appears in Collections:[保健營養系(所) ] 期刊論文

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