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Researchers have discovered {that a} single injection of the antibiotic benzathine penicillin G (BPG) efficiently handled early syphilis simply in addition to the three-injection routine utilized by many clinicians in the US and elsewhere. These findings from a late-stage medical trial counsel the second and third doses of standard BPG remedy don’t present a well being profit.
The outcomes are revealed within the New England Journal of Medication.
“Benzathine penicillin G is highly effective against syphilis, but the three-dose regimen can be burdensome and deter people from attending follow-up visits with their health care providers,” mentioned Carolyn Deal, Ph.D., chief of the enteric and sexually transmitted infections department of NIH’s Nationwide Institute of Allergy and Infectious Illnesses (NIAID).
“The new findings offer welcome evidence for potentially simplifying treatment with an equally effective one-dose regimen, particularly while syphilis rates remain alarmingly high.”
Syphilis is a standard sexually transmitted an infection (STI) attributable to the bacterium Treponema pallidum. America reported 209,253 whole syphilis instances and three,882 congenital syphilis instances in 2023, representing 61% and 108% will increase over 2019 numbers, respectively.
With out therapy, syphilis can lead to neurological and organ harm in addition to extreme being pregnant issues and congenital abnormalities. Syphilis may improve an individual’s chance of buying or transmitting HIV.
BPG is among the few antibiotics identified to successfully deal with syphilis, and stockouts are widespread worldwide. The antibiotic is presently being imported to the US to resolve a nationwide scarcity.
The research was carried out at 10 U.S. websites and enrolled 249 contributors with early syphilis, which encompasses the first, secondary, and early latent phases of illness; 61% of contributors have been dwelling with HIV and 97% have been males.
The contributors have been randomly assigned to obtain both a single intramuscular (IM) injection of BPG 2.4 million items (MU) or a sequence of three IM injections of BPG 2.4 MU at weekly intervals. All contributors have been monitored for security. Organic markers of profitable therapy within the blood—often called the serologic response to remedy—have been examined at six months following therapy.
Some 76% of contributors within the single-dose group had a serologic response to therapy in comparison with 70% of contributors within the three-dose group. The distinction between teams was not statistically vital, even when contributors have been stratified by HIV standing.
One participant developed indicators of neurosyphilis three days after beginning BPG remedy and was excluded from the evaluation. Three critical antagonistic occasions have been reported however weren’t associated to BPG.
“Syphilis has been studied and treated for more than a century, and BPG has been in use for more than 50 years, yet we are still acquiring knowledge to help us optimize treatment,” mentioned Principal Investigator Edward W. Hook III, M.D., emeritus professor of drugs and epidemiology on the College of Alabama at Birmingham.
“We hope these promising results will be complemented by scientific advances in syphilis prevention and diagnosis.”
Based on the research authors, the outcomes from this trial present substantial proof that single-dose BPG 2.4 MU is as efficient as three doses in treating early syphilis. Extra analysis is required to know the total potential of this abbreviated therapy technique and to guage therapeutic approaches for all phases of syphilis, together with late syphilis, latent syphilis of unknown period, and medical neurosyphilis.
The research was carried out by way of the Sexually Transmitted Infections Scientific Trials Group.
Extra data:
Benzathine penicillin G, 1 vs 3 weekly doses, for early syphilis therapy, New England Journal of Medication (2025). DOI: 10.1056/NEJMoa2401802
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Nationwide Institutes of Well being
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One dose of antibiotic treats early syphilis in addition to three doses, medical trial reveals (2025, September 3)
retrieved 3 September 2025
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