매독 편집하기 (부분)

===조기매독 (1기, 2기 조기잠복매독)===

*페니실린요법이 조기매독 치료의 원칙이다. (근거수준 1)

 A   조기매독에서는 benzathine penicillin G 240만 IU 근육주사단회요법이권장된다.<ref name=” Benzathine penicillin G in the treatment of syphilis.”>Smith C, Kamp M, Olansky S, Price EV. Benzathine penicillin G in the treatment of syphilis. Bull World Health Organ 1956;15:1087-96</ref>, <ref name=” Treatment of primary syphilis. “>Elliot WC. Treatment of primary syphilis. J Am Vener Dis Assoc 1976;3:128-35</ref>, <ref name=” Penicillin in the treatment of syphilis. The experience of three decades. “>Idsoe O, Guthrie T, Wilcox RR. Penicillin in the treatment of syphilis. The experience of three decades. Bull World Health Organ 1972;47:1-68</ref>, <ref name=” A randomized trial of enhanced therapy for early syphilis in patients with and without human immunodeficiency virus infection. “>Rolfs RT, Joesoef MR, Hendershot EF, et al. A randomized trial of enhanced therapy for early syphilis in patients with and without human immunodeficiency virus infection. The Syphilis and HIV Study Group. N Engl J Med 1997;337:307-14</ref>

  근육주사 시 양쪽 둔부에 120만 IU씩 각각 주사할 수도 있고, 통증을 경감하기 위해서 리도카인 1% 용액에 혼합하여 주사할 수 있다.

*페니실린 과민반응이 있는 경우 페니실린 탈감작이 우선 고려되어야 하며, 여의치 않을 경우 다음과 같은 대체요법으로 치료한다. (근거수준 2,3)

 조기매독의 대체 항균제 요법
   *Doxycyline 100mg 1일 2회또는 200mg 1일 1회경구 14일요법<ref name=” Doxycycline compared with benzathine penicillin for the treatment of early syphilis.”>Ghanem KG, Erbelding EJ, Cheng WW,  Rompalo AM. Doxycycline compared with benzathine penicillin for the treatment of early syphilis. Clin Infect Dis 2006;42:e45–9 </ref>, <ref name="Doxycycline in early syphilis: a long term follow up.">Harshan V, Jayakumar W. Doxycycline in early syphilis: a long term follow up. Indian J Dermatol 1982;27:119-24</ref>, <ref name="Therapeutic effect of oral doxycycline on syphilis. ">Onoda Y. Therapeutic effect of oral doxycycline on syphilis. Br J Vener Dis 1979;55:110-5</ref>, <ref name="Primary syphilis: serological treatment response to doxycycline/tetracycline versus benzathine penicillin.">Wong T, Singh AE, De P. Primary syphilis: serological treatment response to doxycycline/tetracycline versus benzathine penicillin. Am J Med 2008;121:903-8 </ref>