Abstract

In the United Kingdom, it is recommended that syphilis should be treated with intramuscular daily procaine penicillin with or without oral probenecid for 8 to 21 days. However, it has been argued that this regimen would be unacceptable to patients in terms of daily attendance and volume of drug administered, resulting in poor compliance. To assess the acceptability of and compliance with daily procaine penicillin for 10 to 17 days in patients attending an East London Genito-Urinary Medicine Clinic with a diagnosis of syphilis-treponemal infection. The notes of 210 consecutive patients attending with syphilis-treponemal infection who had been offered treatment with daily procaine penicillin, with or without oral probenecid for 10 to 17 days, were reviewed retrospectively. Of 210 patients who were offered daily procaine penicillin, 42 (20%) declined and were given oral doxycycline, amoxicillin, or depot penicillin injections. Of 168 patients who accepted daily procaine penicillin, depending on the stage of infection, 90 (54%) had 1.8 g of daily procaine penicillin together with oral probenecid 500 mg every 6 hours for 17 days (high-dose regimen), 57 (34%) had 0.6 g of daily procaine penicillin for 10 to 17 days (low-dose regimen), and 21 (12%) had mixed-dose regimens ranging from 0.5 to 2.4 g. Of the 90 who had high-dose regimen, 76 (84%) complied with treatment compared with 50 (88%) of 57 who had low-dose regimen. All 21 patients who had mixed-dose regimens complied fully. Daily procaine penicillin is a well-accepted out-patient regimen with excellent compliance (88% overall) and minimal side effects. Because the high-dose regimen has been shown to achieve treponemicidal levels of penicillin in the cerebrospinal fluid, it is recommended for patients with neurosyphilis or those in whom neurosyphilis cannot be excluded. It also could be considered for patients with concomitant human immunodeficiency virus infection in view of the possible progression to neurosyphilis in those treated with depot penicillin.

Talk to us

Join us for a 30 min session where you can share your feedback and ask us any queries you have

Schedule a call

Disclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.