Impersonation through Kerberos is the most secure answer, as well as the simplest to administrate. Having separate 'synthetic' users when accessing resources like databases means you basically bypass all possibilities for database authorization, get duplicate points of access administration, and that you get zero traceability at the database level (you just see that MySyntheticUser tried to access something, not who was behind it).
Having said this, I should warn you that Microsoft's Kerberos isn't always as straightforward as you would expect. We've had significant trouble getting it to work between pure .NET solutions, IIS, SQL Server 2005, AD domains and Internet Explorer. Most of it was down to getting trust configured exactly right. Also, while I'm not a PHP developer myself, I find some indications that you may have trouble accessing Kerberos library functionality. Find out what support you can get for SSPI. Also, your PHP process must have the necessary permissions to impersonate users, which I believe can be administered through IIS.
I would not necessarily expect all of this to be straightforward or easy, particularly as Microsoft has few incitaments to support non-Microsoft languages and platforms.