From the Department of Pediatrics, Maternal Child and Adolescent/Adult Center for Infectious Disease and Virology, University of Southern California, Los Angeles.
Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California San Diego, La Jolla.
Sex Transm Dis. 2024 Dec 1;51(12):775-779. doi: 10.1097/OLQ.0000000000002057. Epub 2024 Jul 24.
Congenital syphilis rates increased 10-fold from 2012 to 2022 in the United States. Currently, the therapeutic standard of care is 10 days of intravenous aqueous crystalline penicillin G, with very limited evidence for alternatives. A long course of intravenous antibiotic requires hospitalization that is both costly and burdensome for the child and the family. Fortunately, Treponema pallidum retains susceptibility to other antibiotics based on minimum inhibitory concentrations. Based on the evidence of safety and efficacy of different antibiotics for use in neonates, ceftriaxone emerges as a potential parenteral candidate, and amoxicillin emerges as a potential oral candidate for the treatment of congenital syphilis. Other therapeutic alternatives include cefotaxime (where available), ampicillin, doxycycline, cefixime, and linezolid.
先天性梅毒在美国的发病率从 2012 年到 2022 年增加了 10 倍。目前，治疗标准是 10 天静脉注射水剂青霉素 G，可供选择的替代方案非常有限。由于长期静脉注射抗生素需要住院治疗，这对儿童及其家庭来说既昂贵又麻烦。幸运的是，苍白密螺旋体根据最低抑菌浓度仍对其他抗生素敏感。基于不同抗生素在新生儿中的安全性和疗效证据，头孢曲松脱颖而出，成为一种潜在的可供选择的静脉用药物，阿莫西林也成为治疗先天性梅毒的潜在口服候选药物。其他治疗选择包括头孢噻肟（如可用）、氨苄西林、多西环素、头孢克肟和利奈唑胺。
