Correlation Between Changes in Syphilis Treatment and Jarisch-Herxheimer Reaction

Area of Science:

• Urology
• Infectious Diseases
• Public Health

Background:

• Syphilis incidence is increasing globally and in Japan.
• Previous data may not reflect current trends in urological settings.

Purpose of the Study:

• To analyze trends in syphilis consultations at urological clinics in Hyogo Prefecture, Japan.
• To compare patient data and treatment outcomes over two consecutive years.

Main Methods:

• Retrospective data collection from 11 urological clinics over two 1-year periods (Aug 2016-Jul 2018).
• Analysis of patient demographics, rapid plasma reagin (RPR) and Treponema pallidum (TP) antibody tests, clinical stage, therapy, and Jarisch-Herxheimer reactions.
• Statistical comparison between the two study periods.

Main Results:

• 45 new syphilis patients were identified (22 in year 1, 23 in year 2), predominantly male.
• RPR and TP antibody levels remained stable; amoxicillin treatment duration was longer in year 1.
• Jarisch-Herxheimer reactions significantly increased from 13.6% to 60.9% in year 2 (p=0.001).

Conclusions:

• Despite adherence to antibiotic guidelines in the second year, a significant rise in Jarisch-Herxheimer reactions was observed.
• Further research, including follow-up of recurrent cases, is needed to understand these changes in syphilis management.