ArticleSexually transmitted diseases2025
Comparison of 3 Treatment Regimens for Latent Syphilis of Late or Unknown Duration Using Public Health Surveillance Data.
Article in Sexually transmitted diseases, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
4 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Treponemal and Lipoidal Immunoglobulin M Tests in the Diagnosis and Management of Syphilis Among Nonpregnant Adults: A Systematic Review.Sexually transmitted diseases · 2026Pooled it
- Serological response after shorter durations of therapy for syphilis of late latent or unknown duration: What does it mean?Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2026Article
- Strong Real-World Evidence That a Single Dose of Benzathine Penicillin G or a 28-Day Course of Oral Doxycycline Is Not Inferior to 3 Doses of Benzathine Penicillin G for the Treatment of Late Latent or Unknown Duration Syphilis.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2026Article
- Expanding treatment options for syphilis during pregnancy: a review of alternatives to penicillin.Frontiers in global women's health · 2026Review
Corrections and comments
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Authors and funding
6 authors.
Funding
Abstract
backgroundThe Centers for Disease Control and Prevention recommends treating latent syphilis of late/unknown duration (LSUD) with 3 doses of intramuscular benzathine penicillin G (BPG) or 28 days of oral doxycycline. This recommendation lacks high-quality evidence.
methodsUsing public health surveillance data from King County, Washington, we conducted a retrospective cohort study comparing rates of serological cure (≥2-titer reactive plasma reagin [RPR] decline) among persons with LSUD following receipt of 1 of 3 regimens: 1 dose of BPG, 3 doses of BPG, and 28 days of doxycycline. Subjects included persons diagnosed in 2007 to 2020 with an initial RPR ≥1:2 and follow-up RPR testing 1 to 36 months after treatment. We stratified initial RPRs into high and low titer (≥1:32, <1:32) and compared outcomes using Cox proportional hazards.
resultsThe study population included 761 persons with median time from treatment to last RPR/serological cure of 219 days (interquartile range, 114-488 days). Among high-titer persons, serological cure occurred in 36 of 41 (88%), 330 of 376 (88%), and 58 of 64 (88%) receiving single-dose BPG, 3-dose BPG, and doxycycline, respectively. Among low-titer persons, serological cure occurred in 4 of 13 (31%), 114 of 235 (49%), and 14 of 30 (47%) receiving single-dose BPG, 3-dose BPG, and doxycycline, respectively. Controlling for initial RPR, serological cure did not differ between high-titer persons receiving 1- and 3-dose BPG (adjusted hazard ratio, 0.89; 95% confidence interval, 0.63-1.26) or 1-dose BPG and 28 days of doxycycline (adjusted hazard ratio, 1.03; 95% confidence interval, 0.68-1.58).
conclusionsSerological outcomes in high-titer LSUD after 1 dose of BPG, 3 doses of BPG, and 28 days of doxycycline are similar.
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