阿奇霉素治疗早期梅毒及其耐药的进展

Treatment with and resistance to azithromycin in early syphilis

青霉素是目前治疗梅毒的最佳方法，但在应用中仍存在着一定的局限性。阿奇霉素治疗早期梅毒简便可行、依从性好，且多项研究已证实其疗效，可作为青霉素过敏患者的替代治疗方案。同时阿奇霉素在梅毒预防控制的现场实施和用于治疗其他性病病原体合并感染有一定的优越性。近年来，出现基因突变引起的耐阿奇霉素的梅毒螺旋体，导致阿奇霉素治疗早期梅毒失败，并在一定的网络中传播，影响它在梅毒治疗中的进一步应用。

At present, penicillin is recommended as the optimal regimen for syphilis, but there are still limitations in its application. In treatment for early syphilis, azithromycin regimen is easy to implement with a good compliance, and its efficacy has been proved by several studies, resulting in recommending this regimen as alternative treatment of early syphilis among those patients who are allergic to penicillin. Meanwhile, azithromycin regimen has its advantage in applying in the field and simultaneously treating co-infection with other sexually transmitted infections. Recently, azithromycin-resistant Treponema pallidum due to gene mutation has occurred, resulting in the treatment failure in early syphilis, and transmitted within sexual network, which has tempered further use of this regimen.