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Table 2 Syphilis treatment regimens, nontreponemal antibody tests, estimated proportions with serological cure and serological non-response at time points after therapy

From: A systematic review of syphilis serological treatment outcomes in HIV-infected and HIV-uninfected persons: rethinking the significance of serological non-responsiveness and the serofast state after therapy

First Author Main syphilis treatment regimens Alternative syphilis treatment regimens Non-treponemal antibody test % Serological cure (≥ 4-fold decline in nontreponemal titers or seroreversion) % Serological non-response (< 4-fold decline in nontreponemal titers) Time period assessed after therapy
Dionne-Odom 1–3 doses benzathine PCN G (2.4 MU IM weekly) None RPR 66.8 26.6 400 days
Fiumara 2 doses benzathine PCN G (2.4 MU IM weekly) Tetracycline RPR 64.1 33.6 < 5 years
Ghanem (2007) [23] Benzathine PCN G (1 dose for early syphilis, 3 doses for late syphilis) Doxycycline RPR 87.9 9.1 400 days
Ghanem (2008) [24] Benzathine PCN G (1 dose for early syphilis, 3 doses for late syphilis) Doxycycline RPR 60.5 14.4 9–12 monthsa
Goemen 3 doses benzathine PCN G (2.4 MU IM weekly) None RPR 23.4 71.3 6 months
27.5 62.5 12 months
40.0 56.7 24 months
Jinno 1–3 doses benzathine PCN G (2.4 MU IM weekly) Doxycycline RPR 90.9 9.1 9–12 months
Knaute 1–3 doses benzathine PCN G (2.4 MU IM weekly); aqueous PCN G for tertiary syphilis None VDRL 96.3 3.7 6 months
97.7 2.3 9 months
99.1 0.9 12–18 months
Li 2 doses benzathine PCN G (2.4 MU IM weekly) Not reported RPR 85.0 15.0 6 months
Long 1–3 doses benzathine PCN G (2.4 MU IM weekly) Doxycycline RPR 93.4 6.6 12 months
Malone 3 doses benzathine PCN G (2.4 MU IM weekly) PCN G procaine with probenecid or IV PCN G VDRL 79.8 2.3 12 months
Manavi 1–3 doses benzathine PCN G (2.4 MU IM weekly) Doxycycline for 21 days VDRL 68.2 31.4 12 months
Reidner 1 dose benzathine PCN (2.4 MU IM) Azithromycin RPR 96.4 3.6 9 months
Rolfs 1 dose benzathine PCN (2.4 MU IM) 1 dose benzathine PCN enhanced with 10 day course of amoxicillin and probenecid RPR 89.3 10.7 6 months
90.3 9.7 12 months
Romanowski 1 dose benzathine PCN (2.4 MU IM) Tetracycline or erythromycin RPR 77.9 22.1 6 months
88.8 11.2 12 months
95.1 4.9 24 months
Seña 1 dose benzathine PCN (2.4 MU IM) or azithromycin (2g PO) Doxycycline RPR 78.5 20.5 6 months
Tittes 1–3 doses benzathine PCN (2.4 MU IM weekly) None VDRL 95.2 4.8 6 months
Tong 1–3 doses benzathine PCN (2.4 MU IM weekly) Azithromycin IM or IV RPR 64.1 35.9 6 months
65.6 34.4 12 months
Tsai 1 dose benzathine PCN (2.4MU IM) Doxycycline RPR 69.5 25.9 6 months
67.8 32.3 12 months
Wu 1 dose benzathine PCN or azithromycin 3 doses of benzathine PCN or doxycycline RPR 74.7 25.3 6 months
Yang 1–3 doses benzathine PCN (doses NR) None RPR 79.1 5.6 6 months
70.9 4.2 12 months
  1. PCN penicillin, MU million units, IM intramuscular, IV intravenous, RPR rapid plasma reagin, VDRL venereal disease research laboratory; NR not reported
  2. a Serological outcomes were determined at ≥ 9 months after treatment for early syphilis or ≥ 12 months for late syphilis