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RecruitingNCT04958122Updated May 4, 2026

Cefixime Clinical Trial

A Phase 3 interventional study of Cefixime 400mg and benzathine penicillin in Syphilis and Human Immunodeficiency Virus, sponsored by University of Southern California. Recruiting at 1 site in United States. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-05-04.

Sponsored by University of Southern California · Phase 3, Interventional, and Treatment

From the registry’s dates

  • Started Jun 2021; still recruiting 5 years 4 months later.
Phase
Phase 3
Study type
Interventional
Enrollment
400
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study summary

This study aims to evaluate the efficacy of cefixime compared to benzathine penicillin G in the treatment of syphilis.

Read the detailed description

This will be a randomized, multisite, open-label, non-inferiority clinical trial to evaluate the effectiveness of cefixime (400mg orally, twice a day, for 10 days) compared to benzathine penicillin G (2.4 million units, intramuscularly) in patients with and without HIV infection. In total, 400 participants with early syphilis will be enrolled from 9 clinical sites in the U.S. and Peru. Participants will participate in follow-ups to monitor clinical outcomes and serological response (RPR titer) every 3 months for 9 months. Study findings may identify an efficacious alternative syphilis treatment to penicillin, effective for people living with HIV infection, to help address the crisis of penicillin shortages and offer options for those with penicillin allergy.

02

Conditions studied

  • Syphilis
  • Human Immunodeficiency Virus

Keywords

  • Cefixime
  • Treponema pallidum
  • Penicillin
  • Early Syphilis
03

In context

Syphilis

126 studies on the registry are indexed under Syphilis; 34 are open to participants now.

This study's planned enrollment of 400 is above the median of 354 across 85 interventional studies indexed under Syphilis.

Browse Syphilis studies →

Lead sponsor

University of Southern California is the lead sponsor of 791 studies on the registry; 136 are open to participants now.

Of its 70 completed or terminated interventional studies of FDA-regulated products, 32 (46%) have results posted.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • Diagnosed cases of primary, secondary, or early latent syphilis with RPR titer ≥1:8 within 3 weeks prior to enrollment
  • 18 years of age or older
  • Able to provide
  • Individuals with infection must be on treatment for HIV infection and virologically suppressed (viral load \<200 copies/mL) or have a ≥ 350 cells/mm3 according to most recent labs before study enrollment

Exclusion criteria

Exclusion Criteria:

  • Pregnancy or a positive pregnancy test on the day of enrollment
  • Patients showing signs and symptoms of neurosyphilis
  • Serofast RPR titer, defined as persistently positive RPR titer without more than 4-fold (2-titer level) change for 12 months or greater
  • Recent (within the past 7 days) or concomitant antimicrobial therapy with activity against syphilis, namely azithromycin, doxycycline, ceftriaxone, or other beta-lactam antibiotics (e.g. amoxicillin)
  • Individuals with infection who report HIV treatment interruption for more than 4 weeks since their most recent viral load or CD4 test
  • Self-reported allergy to cephalosporins or penicillin
  • Unwilling or unable to attend follow-up visits
Terms in these criteria, in plain language(3)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

HIV

The human immunodeficiency virus, which weakens the immune system.

Many studies now accept people whose HIV is controlled on treatment, judged by the viral load and the CD4 count. Check the limits this study sets.

CD4 count

The number of CD4 cells, a type of white blood cell, in a given amount of blood. It is used to follow how well the immune system is doing in HIV.

05

Study design

Phase
Phase 3
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
400 participants (estimated)

Study arms

  • Experimental
    Cefixime

    Oral cefixime 400mg, taken twice a day for 10 days

    Drug: Cefixime 400mg

  • Active comparator
    Benzathine Penicillin G

    Single intramuscular injection of 2.4 million units of benzathine penicillin G

    Drug: benzathine penicillin

Interventions

  • Oral cefixime 400 mg, one capsule, twice a day for 10 days

    Also known as: supprax

  • Standard of care benzathine penicillin G, one intramuscular injection, 2.4MU

    Also known as: bicillin

06

What researchers measure

Primary outcomes

  1. Response to treatment

    Percentage of cefixime participants with a 4-fold decrease or greater in the serum RPR titer 3 or 6 months after treatment completion

    Time frame: 6 months

07

Study locations

1 of 1 sites recruiting
08

References and documents

Individual participant data

Plan to share: No — No IPD will be shared with other researchers

No publications or documents are linked to this record.

09

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on May 4, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT04958122
Collaborators
AIDS Healthcare Foundation, Universidad Peruana Cayetano Heredia
Responsible party
Jeffrey D Klausner (Clinical Professor, University of Southern California) — Principal investigator
First posted
Jul 12, 2021
Start date
Jun 20, 2021
Primary completion
Jan 1, 2027 (estimated)
Completion
Jun 30, 2027 (estimated)
Last update
May 4, 2026

Study contacts

Jeffrey D Klausner
Contact
jdklausner@med.usc.edu
(415) 876-8901
Jeffrey D Klausner, MD MPH
principal investigator · University of Southern California

Oversight

Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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