Penicillin treatment of early syphilis

Abstract

1. 1. In an eight-day period of therapy for early syphilis a total dose of 2.4 million units has given as good results as 5 million units. 2. 2. When aqueous solutions of penicillin are used, individual injections should be given every two to four hours. 3. 3. When POB is used, daily injections of 300,000 to 600,000 units are advised for fifteen days although an occasional day can be skipped and the period of treatment prolonged accordingly. 4. 4. The cumulative “failure” rates for eight-day schedules of therapy with at least 2.4 million units of penicillin have been about 20 per cent. Many of the so-called failures were probably due to reinfections. 5. 5. Data on fifteen-day schedules of therapy are less adequate than on eight-day schedules but the former period of treatment seems to have given better results than the latter. 6. 6. A new slowly absorbed preparation of penicillin (procaine penicillin G in oil gelled with 2 per cent aluminum monostearate) promises to simplify the treatment of early syphilis. It now seems probable that an injection of 1.2 million units of this preparation once a week for two weeks, or better, two injections of 600,000 unitst wice a week for three weeks will give the same penicillin action as daily injections of 300,000 units of POB for fifteen days. 7. 7. Patients given rapid treatment of early syphilis must be observed at frequent intervals for at least two years with quantitative serologic tests for syphilis. About 75 per cent of successfully treated patients become seronegative within six months after treatment. The other 25 per cent may have low reagin titers for varying periods after six months but they do not require retreatment unless the titers show evidence of relapse or reinfection.