Could late-latent syphilis be treated with a single subcutaneous infusion of long-acting penicillin?

Thel K Hla; Sam Salman; Joseph Kado; Brioni R Moore; Laurens Manning

doi:10.1071/SH24003

Could late-latent syphilis be treated with a single subcutaneous infusion of long-acting penicillin?

Sex Health. 2024 Mar:21:SH24003. doi: 10.1071/SH24003.

Authors

Thel K Hla¹, Sam Salman², Joseph Kado³, Brioni R Moore⁴, Laurens Manning¹

Affiliations

¹ Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia, Perth, WA, Australia; and Medical School, University of Western Australia, Perth, WA, Australia; and Department of Infectious Diseases, Fiona Stanley Hospital, Perth, WA, Australia.
² Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia, Perth, WA, Australia; and Medical School, University of Western Australia, Perth, WA, Australia; and Clinical Pharmacology and Toxicology Unit, PathWest, WA, Australia.
³ Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia, Perth, WA, Australia; and Medical School, University of Western Australia, Perth, WA, Australia.
⁴ Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia, Perth, WA, Australia; and Medical School, University of Western Australia, Perth, WA, Australia; and Curtin Medical School, Curtin University, Perth, WA, Australia.

PMID: 38527362
DOI: 10.1071/SH24003

Abstract

Syphilis is an important global health threat and little has changed in its treatment since the mid-20th century. For late-latent or syphilis infection of unknown duration, the standard treatment of multiple intramuscular injections of benzathine penicillin G (BPG) are associated with significant pain and distress to clients and caregivers, negatively impacting on treatment completion. Based on pharmacokinetic modelling from a Phase I study of subcutaneous infusion of high dose BPG (SCIP), we present its feasibility, safety and tolerability for treatment of syphilis in a single infusion. SCIP leads to more sustained penicillin concentrations above the desired target with less reported pain and reduced clinic visits.

Publication types

Clinical Trial, Phase I

MeSH terms

Anti-Bacterial Agents / therapeutic use
Humans
Infusions, Subcutaneous
Injections, Intramuscular
Pain / drug therapy
Penicillin G Benzathine / therapeutic use
Syphilis* / drug therapy

Substances

Penicillin G Benzathine
Anti-Bacterial Agents