Review of Current Evidence and Comparison of Guidelines for ...
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EUR/03/5045931<br />
page 26<br />
Table 7<br />
<strong>Evidence</strong> <strong>for</strong> Non Penicillin Treatments<br />
Authors Ref Design <strong>of</strong> study Patients Dose Assessment<br />
<strong>of</strong> Outcome<br />
Harshan V,<br />
Javakumar W<br />
1982<br />
Yoichi Onada<br />
1979<br />
Schoeter AL ,<br />
Lucas JB, Price<br />
EV, Falcone VH<br />
1972<br />
Fern<strong>and</strong>o WL<br />
1969<br />
Hook III EW,<br />
Roddy RE,<br />
H<strong>and</strong>sfield HH.<br />
1988<br />
Moorthy TT, Lee<br />
CT, Lim KB, Tan<br />
T. 1987<br />
Katsambas A,<br />
Adoniou C,<br />
Katsarou A,<br />
Kerkidou A,<br />
Stratigos J.<br />
1987<br />
109 Open, non-<br />
r<strong>and</strong>omized,<br />
non-comparative<br />
study <strong>of</strong><br />
doxycycline in<br />
early syphilis<br />
110 Open, non<br />
r<strong>and</strong>omized, non<br />
comparative<br />
study <strong>of</strong> oral<br />
doxycycline<br />
111 Multicentre,<br />
prospective, non-<br />
r<strong>and</strong>omized,<br />
treatment<br />
comparison <strong>of</strong><br />
PPB, BBP,<br />
tetracycline,<br />
erythromycin<br />
112 Non-r<strong>and</strong>omized,<br />
prospective,<br />
single centre trial<br />
study <strong>of</strong><br />
erythromycin<br />
81 Prospective,<br />
non-r<strong>and</strong>omized,<br />
non-comparative<br />
trial <strong>of</strong><br />
ceftriaxone<br />
82 R<strong>and</strong>omized,<br />
open comparison<br />
study <strong>of</strong><br />
ceftriaxone <strong>and</strong><br />
BBP<br />
113 R<strong>and</strong>omized<br />
comparison<br />
study <strong>of</strong><br />
Ceftriaxone <strong>and</strong><br />
BBP<br />
n=40<br />
P/S/E<br />
n = 51<br />
P E- 5<br />
S – 10<br />
AC – 20<br />
LL – 16<br />
n = 586<br />
P/S<br />
PBP – 162<br />
BBP – 100<br />
Erythromycin<br />
(30g) – 144,<br />
(20g) – 71<br />
Tetracycline<br />
– 107<br />
n=34<br />
P – 20<br />
S – 13<br />
E – 1<br />
n = 21<br />
P/S<br />
n = 21<br />
all P<br />
n = 36<br />
P/S 18 in<br />
both<br />
treatment<br />
groups<br />
100 mg od <strong>for</strong><br />
15 days<br />
100 mg bd <strong>for</strong><br />
28 days,<br />
repeated<br />
every 3 or 4<br />
months <strong>for</strong> 2–<br />
93 months<br />
PBP 4.8 MU<br />
IM<br />
BBP 2.4 MU<br />
IM,<br />
Doxycycline 2<br />
g/day <strong>for</strong> 10<br />
days or 3<br />
g/day <strong>for</strong> 10<br />
days<br />
Tetracycline 3<br />
g/day <strong>for</strong> 10<br />
days<br />
500 mg 6<br />
hourly <strong>for</strong> 10<br />
days (20g<br />
total)<br />
250 mg/day<br />
<strong>for</strong> 10 days<br />
or 500 mg<br />
every 48<br />
hours <strong>for</strong> 5<br />
doses<br />
(i)Ceftriaxone<br />
3 g one dose<br />
(ii)Ceftriaxone<br />
2g/day 2<br />
doses<br />
(iii)Ceftriaxone<br />
2g/day 5<br />
doses<br />
(iv)BBP 2.4<br />
mu IM once<br />
Ceftriaxone<br />
1g/ day every<br />
3 days <strong>for</strong> 4<br />
doses<br />
BBP 11.2 mu<br />
total over 35<br />
days<br />
VDRL titre<br />
reduced by 4-fold<br />
dilution from<br />
baseline or by<br />
clinical lesions<br />
No clinical<br />
relapse. All<br />
CSF tests<br />
normal<br />
No treatment<br />
failures<br />
1 patient was<br />
retreated in<br />
the regime,<br />
none in other<br />
regimes<br />
2–93 months<br />
37 patients<br />
at 24<br />
months.<br />
Retreatment<br />
rates<br />
PPB =<br />
10.8%<br />
BBP =<br />
11.4%<br />
Erythromycin<br />
30g= 21.3%<br />
20g= 29.9%<br />
Tetracycline<br />
= 12.7%<br />
22 patients<br />
to 6 months<br />
4 patients to<br />
24 months<br />
Serology<br />
per<strong>for</strong>med<br />
on 16<br />
patients at<br />
12 weeks<br />
18/21<br />
followed to 6<br />
months<br />
17/21<br />
followed to<br />
12 months<br />
0 failures 0 failures 94% both<br />
groups <strong>for</strong> 3<br />
months<br />
73% both<br />
groups <strong>for</strong> 6<br />
months