More than half of the new syphilis cases reported in San Francisco in 2004 were resistant to the standard antibiotic treatment azithromycin, city health officials report in the journal Clinical Infectious Diseases. Since the late 1990s, doctors and public health clinics have used short courses of the oral drug to treat syphilis in place of more painful injections of penicillin or longer courses of other oral antibiotic pills. But studies have shown azithromycin-resistant syphilis to be on the rise throughout the United States--and around the world. San Francisco researchers report that about 4% of syphilis cases recorded in the city in 2003 were resistant to the drug, rising to about 41% in 2003. That percentage climbed to 56% in 2004.
Health experts say that physicians in the city should no longer offer azithromycin treatment for the sexually transmitted disease and instead should fall back on the older standard treatment of penicillin injections or the oral antibiotic doxycline for patients allergic to penicillin. Patients who previously have been treated with azithromycin also must be given follow-up tests to ensure that they are cured of the STD because the virus can lurk undetected inside the body after the initial outbreak of sores fades. Long-term syphilis infection can attack the brain and cause dementia, paralysis, and death.
Although it appeared in the mid 1990s as though syphilis were on the verge of being wiped out in the United States, the STD has seen a dramatic resurgence during the past five years, particularly among gay and bisexual men. Most new cases of the disease reported in urban centers around the country are among men who have sex with men, say health experts. San Francisco reported five new syphilis cases in 1999, but that number soared to 340 cases in 2004, almost all of which were diagnosed among gay and bisexual men. (Advocate.com)
