Oral linezolid compared with benzathine penicillin G for treatment of early syphilis in adults (Trep-AB Study) in Spain: a prospective, open-label, non-inferiority, randomised controlled trial
RCT (n=59) found efficacy of linezolid (600mg daily for 5 days) did not meet non-inferiority criteria compared with benzathine penicillin G 9 (70% vs 100% response rate, respectively). Number of drug-related adverse events (all mild/moderate) was similar in both treatment groups.
Source:
The Lancet Infectious Diseases
SPS commentary:
Current WHO recommendations for the treatment for all early stages of syphilis is injectable benzathine penicillin G administered intramuscularly as a single dose of 2.4 million units.
A related comment discusses the alternative treatments and their limitations. It notes that despite the negative outcome in the current study, researchers should continue to undertake and support studies to repurpose older, widely available antibiotics for syphilis.