Drug-resistant syphilis is widespread in San Francisco
January 26 2006 1:00 AM ET
More than half of
the new syphilis cases reported in San Francisco in
2004 were resistant to the standard antibiotic treatment
azithromycin, city health officials report in the
journal Clinical Infectious Diseases. Since the late
1990s, doctors and public health clinics have used short
courses of the oral drug to treat syphilis in place of
more painful injections of penicillin or longer
courses of other oral antibiotic pills. But studies
have shown azithromycin-resistant syphilis to be on the rise
throughout the United States—and around the
world. San Francisco researchers report that about 4%
of syphilis cases recorded in the city in 2003 were
resistant to the drug, rising to about 41% in 2003. That
percentage climbed to 56% in 2004.
say that physicians in the city should no longer offer
azithromycin treatment for the sexually transmitted disease
and instead should fall back on the older standard
treatment of penicillin injections or the oral
antibiotic doxycline for patients allergic to penicillin.
Patients who previously have been treated with azithromycin
also must be given follow-up tests to ensure that they
are cured of the STD because the virus can lurk
undetected inside the body after the initial outbreak
of sores fades. Long-term syphilis infection can attack the
brain and cause dementia, paralysis, and death.
appeared in the mid 1990s as though syphilis were on the
verge of being wiped out in the United States, the STD has
seen a dramatic resurgence during the past five years,
particularly among gay and bisexual men. Most new
cases of the disease reported in urban centers around
the country are among men who have sex with men, say health
experts. San Francisco reported five new syphilis cases in
1999, but that number soared to 340 cases in 2004,
almost all of which were diagnosed among gay and
bisexual men. (Advocate.com)
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