Antibiotic-Resistant Syphilis Spreading

A fast-spreading mutant strain of syphilis has proved resistant to the antibiotic pills that are offered to some patients as an alternative to painful penicillin shots. Since the late 1990s, doctors and public health clinics have been giving azithromycin to some syphilis patients because the long-acting antibiotic pill was highly effective and easy to use.

After syphilis sores disappear, the disease can silently attack the brain and cause dementia, paralysis and death. Penicillin has long been the recommended treatment for syphilis. But it must be given in two buttocks injections much more painful than typical shots, because a large amount of the solution must be forced into the muscle.

Syphilis decreased in the United States through the 1990s, then climbed 19 percent from 2000 to 2003 to about 7,100 cases, according to the Centers for Disease Control and Prevention. The CDC attributed the spike to a twelvefold rise in cases among gay and bisexual men, many of whom are also infected with the AIDS virus.

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