Villarreal Diana D, Babalola Chibuzor M
Department of Pediatrics, Maternal Child and Adolescent/Adult Center for Infectious Disease and Virology, University of Southern California, 1100 N. State Street, IRD112, Los Angeles, CA, 90033, USA.
Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
Curr HIV/AIDS Rep. 2025 Mar 13;22(1):22. doi: 10.1007/s11904-025-00725-4.
This review examines the growing need for alternative technologies to address the resurgence of syphilis, particularly its congenital and late-stage manifestations. It explores current treatment paradigms, highlights the limitations of penicillin, and evaluates emerging evidence on new therapies and diagnostics to inform future strategies.
Recent breakthroughs in Treponema pallidum culture techniques have enabled antibiotic susceptibility testing, expanding knowledge on both established and emerging treatment options. Alternatives like ceftriaxone, doxycycline, cefixime, and dalbavancin show promise, with other candidates in trials, though evidence is limited beyond early-stage syphilis. Shortened penicillin regimens also challenge historical assumptions about treatment duration. Advanced molecular diagnostics may complement currently limited serologic monitoring to improve evaluations in healthcare and research. While penicillin remains effective, its limitations necessitate alternatives. Emerging antibiotics and improved diagnostics offer opportunities to simplify treatment and enhance care. Future robust trials should validate new treatments, refine dosing strategies, and integrate innovative diagnostics, particularly including underserved and vulnerable populations.
本综述探讨了应对梅毒卷土重来，尤其是其先天性和晚期表现，对替代技术的需求日益增长的情况。它探讨了当前的治疗模式，强调了青霉素的局限性，并评估了关于新疗法和诊断方法的新证据，以为未来策略提供参考。
梅毒螺旋体培养技术的最新突破使抗生素敏感性测试成为可能，扩展了对既定和新兴治疗选择的认识。头孢曲松、多西环素、头孢克肟和达巴万星等替代药物显示出前景，还有其他候选药物正在进行试验，不过除早期梅毒外，证据有限。缩短的青霉素治疗方案也对关于治疗持续时间的传统假设提出了挑战。先进的分子诊断方法可以补充目前有限的血清学监测，以改善医疗保健和研究中的评估。虽然青霉素仍然有效，但其局限性使得需要替代药物。新兴抗生素和改进的诊断方法为简化治疗和加强护理提供了机会。未来有力的试验应验证新疗法，完善给药策略，并整合创新诊断方法，尤其要纳入服务不足和弱势群体。
