# Clinical trial comparing the effectiveness of cefixime versus penicillin G for treatment of early syphilis

> **NIH NIH R01** · UNIVERSITY OF CALIFORNIA LOS ANGELES · 2020 · $662,921

## Abstract

PROJECT ABSTRACT
The proposed project is designed to evaluate the effectiveness of cefixime (400mg, twice a day, for 10 days)
compared to benzathine penicillin G (2.4 million units, intramuscularly) in patients with and without HIV
infection. Syphilis rates have been increasing both in the US and internationally. Incidence is higher among
men-who-have-sex-with-men and more importantly in individuals with HIV infection. Currently, penicillin is used
to treat syphilis in patients with and without HIV infection. Doxycycline, tetracycline and ceftriaxone are
alternative treatments for non-pregnant patients who are allergic to penicillin. Existing treatment alternatives
are based on clinical experience, a limited number of small clinical trials, and case series, but each poses
clinical challenges. New, safe and efficacious antibiotic treatment options are needed.
In this proposal, we will build upon our successful pilot study to conduct a randomized, multisite, open-label, non-
inferiority clinical trial to evaluate the effectiveness of cefixime (400mg, twice a day, for 10 days) compared to
benzathine penicillin G (2.4 million units, intramuscularly) in patients with and without HIV infection. We will enroll
400 participants with early syphilis infection from 9 clinical sites in the U.S. and Peru. We will follow the
participants to monitor clinical progress and serological response (RPR titer) every 3 months for 9 months. Our
hypothesis is that cefixime will be non-inferior to penicillin in treating syphilis, shown as a 4-fold decrease in
RPR titer from enrollment to 6-months after treatment administration. These are the two specific aims of our
proposal. AIM 1: Evaluate the effectiveness of cefixime in the treatment of early syphilis when compared to
benzathine penicillin G. AIM 2: Determine the predictors of treatment failure among participants.
The 5 year project has 4 phases. Phase I will last 9 months and will involve the development of study
instruments, staff training on recruitment, enrollment, and data collection. Phase II will last 36 months and will
involve recruitment and enrollment of patients. Phase III which will last 45 months, but will start simultaneously
as stage II, and will include the patient follow-up period. Phase IV will last 6 months and in that time, the data
will be analyzed and disseminated.

## Key facts

- **NIH application ID:** 10079905
- **Project number:** 1R01AI155217-01
- **Recipient organization:** UNIVERSITY OF CALIFORNIA LOS ANGELES
- **Principal Investigator:** Jeffrey David Klausner
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $662,921
- **Award type:** 1
- **Project period:** 2020-07-13 → 2021-01-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10079905

## Citation

> US National Institutes of Health, RePORTER application 10079905, Clinical trial comparing the effectiveness of cefixime versus penicillin G for treatment of early syphilis (1R01AI155217-01). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10079905. Licensed CC0.

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