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1. Original Article
Therapeutic Effect Of
Ceftriaxone and Penicillin G
Procaine in Patients With
Early-Stage Syphilis
Yang Liu, Chen Liu, Chao Huang,
Lingling Hu, Hongyang Wang

2. Incidence
Increase rapidly
Peniciline
Is the first line
medicine, but still
NOT SUFFICIENT
Ceftriaxon
Potential anti-
syphilis drug,
reducing
the serum fixation
rate
AIM
To compare he
therapeutic effect
of ceftriaxone and
penicillin G
procaine
EARLY STAGE
SYPHILIS

3. METHODS
60 patients with early syphilis, during May 2014 - May
2015
1. Conformed to diagnostic
criteria for early syphilis;
2. Negative for HIV;
3. Signed informed consent
with good compliance;
4. Not having received
medication
Inclusion
1. Combined with low
immunity;
2. Diagnosed as tumors;
3. Concurrent with severe
diseases of liver, heart
and kidney;
4. Women during lactation
or pregnancy
Exclusion

4. Sample (n=60)
Penicilin group (N=30)Ceftriaxon group (N=30)
 16 males
 14 females
 age 22-67 years (average,
35.4±9.5 years)
 primary syphilis (12 cases),
 secondary syphilis (13 cases)
 early latent syphilis (5 cases)
 14 males
 16 females
 age 23-68 years (average,
34.6±9.4 years)
 primary syphilis (14 cases),
 secondary syphilis (12 cases)
 early latent syphilis (4 cases)
1.0 g CTRX, once daily, 10 days
800.000 unit penicillin G
procaine, once daily, 15 days

5. Indicators Statistical process
• Using SPSS 21.0
• Means data
compared by t-test
• Count data
compared by chi-
square
• P < 0.05, significant
• Followed up for 12
months
• Receive TRUS Test in 1st,
3rd, 6th, 9th and 12th
month after treatment
• Evaluation by
subsidence of skin
lesions and serologic
test

6. group
Total
number of
case
Number of
cases
achieving
subsidence
of skin
lesion
Number of
cases not
achieving
subsidence
of skin
lesions
Subsidence
rate
CTRX group 30 27 3 90.00%
Penicilin G
procaine
30 20 10 66.67%
X2 Value 4.812
P value 0.028
Comparison of subsidence of skin lesions between
the two groups within 1 week

7. group
1 month
[n (%)]
3
months
[n (%)]
6
months
[n (%)]
9
months
[n (%)]
12
months
[n (%)]
CTRX
group
6 (20.00)
13
(43.33)
23
(76.67)
28
(93.33)
30
(10.00)
Penicilin
G
procaine
1 (3.33) 7 (23.33)
18
(60.00)
25
(83.33)
28
(93.33)
X2 Value 4.043 2.700 1.926 1.456 2.069
P value 0.044 0.100 0.165 0.228 0.150
Comparison of negative
conversion rate in trust

8. group
Total number
of case
Number of
cases with
sero-resistence
Incidence of
sero-resistance
CTRX group 30 5 16.67%
Penicilin G
procaine
30 7 23.33%
X2 Value 0.417
P value 0.519
Comparison of incidence of sero-resistance
between the two groups

9. Syphilis
Primary Secondary Tertiary
Latent prenatal
Traponema
pallidum
Sexual contact
Horizontal
transmission
Blood tranfussion

10. Primary Syphilis
Sign :
GENITAL ULCERATION
Large number Traponema pallidum enter blood
circulation (6-8 weeks)
Symptom :
Low fever, physical discomfort, lymph node swelling
Secondary Syphilis

11. Secondary Syphilis
Immune response activated
Traponema pallidum killed
Symptom disappeared
Residual Traponema pallidum attack CNS and
cardiovascular

12. Congenital Syphilis
Pregnant women having
primary, secondary, or early
latent syphilis
are associated with
very high probability
of transmitting syphilis to fetus

13. Symptoms

14. Syphilis Treatment
Penicilin G procaine Ceftriaxon
 First line drug
 most effective drug
 Concentration maintained
for about 1 week
 no penicillin-resistant
strains
× Poor penetration across
the blood-brain barrier
× Failed to achieve a stable
concentration in CSF
 Excellent inhibitory activity on
Treponema pallidum
 Works by inhibiting the cell
wall synthesis, thus inhibiting
the proliferation
 Poor affinity with plasma
protein
 Can penetrate BBB and CSF
 Longer half life, high
bioavailability and safety

15. Time Result Note
Week 1 subsidence rate higher in
CTRX group
1st month Negative conversion rate in
TRUST in CTRX group was
considerably higher
• CTRX has a
longer half-life
• CTRX can
persistently kill
Treponema
pallidum at the
conventional
dose
3rd month Negative conversion rate in
TRUST
did not show significant
difference between the
two groups
The two groups
had comparable
effect in treating
early syphilis
6th month
9th month
12th month

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