How Much Penicillin Cures Early Syphilis?
Authors: Daniel M. Musher
Journal: Annals of Internal Medicine (1988)

Editorials1 December 1988How Much Penicillin Cures Early Syphilis?Daniel M. Musher, MDDaniel M. Musher, MDSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-109-11-849 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptIf there has seemed to be one fixed point in the therapeutic armamentarium, one axiom of medical treatment, it has been that early syphilis is cured by 2.4 mIU (million international units) of benzathine penicillin. As physicians, we have tended to overlook the fact that the major clinical trials in the treatment of syphilis utilized aqueous or procaine penicillin and, later, alum-precipitated procaine penicillin, whereas we now use benzathine penicillin. We have also tended to ignore the occasional therapeutic failure, being all too ready to attribute it to reinfection. Finally, we have been content with serologic observations rather than forcing...References1. Fiumara N. The treatment of secondary syphilis: an evaluation of 204 patients. Sex Transmit Dis. 1977;4:96-9. CrossrefMedlineGoogle Scholar2. Musher D and Knox J. Syphilis and yaws. In: Schell RF, Musher DM, eds., Pathogenesis and Immunology of Treponemal Infection. New York: Marcel Dekker; 1983:101-20. Google Scholar3. Musher D. Syphilis. Infect Dis Clin North Am. 1987;1:83-93. CrossrefMedlineGoogle Scholar4. . Treponematoses research. Report of A WHO scientific group. Geneva, Switzerland: World Health Organization Technical Report Series No. 455; 1970. Google Scholar5. Lukehart S, Hook E, Baker-Zander S, Collier A, Critchlow C, and Handsfield H. Invasion of the central nervous system by Treponema pallidum: implications for diagnosis and therapy. Ann Intern Med. 1988;109:855-862. LinkGoogle Scholar6. Swartz M. Neurosyphilis. In: Holmes KK, Mardh PA, Sparling PF, Wiesner PJ, eds., Sexually Transmitted Diseases. New York: McGraw-Hill; 1984:313-34. Google Scholar7. Musher D. Evaluation and management of an asymptomatic patient with a positive VDRL reaction. In: Remington JS, Swartz MN, eds., Current Clinical Topics in Infectious Diseases. No. 9. New York: McGraw-Hill; 1988:147-57. Google Scholar8. Muller F, Moskophidis M, and Prange H. Demonstration of locally synthesized immunoglobulin M antibodies to Treponema pallidum in the central nervous system of patients with untreated neurosyphilis. J Neuroimmunol. 1984;7:43-54. CrossrefMedlineGoogle Scholar9. Moore J. Penicillin in Syphilis. Springfield, Illinois: Charles C Thomas; 1946. Google Scholar10. Willcox R. Treatment of early venereal syphilis with antibiotics. Br J Vener Dis. 1962;38:109-25. MedlineGoogle Scholar11. United States Public Health Service. Syphilis: Modern Diagnosis and Management. United States Department of Health, Education and Welfare. Public Health Service Publication No. 743. Washington, DC: United States Government Printing Office; 1960. Google Scholar12. Leslie N. Treatment of early infectious syphilis with benzathine penicillin G. In: Proceedings of World Forum on Syphilis and Other Treponematoses. Washington, DC. September 4-8, 1962. United States Department of Health, Education and Welfare. Public Health Service Publication No. 997, Washington, DC; 1964:217-21. Google Scholar13. Conn H ed., Current Therapy. Latest Approved Methods of Treatment for Practicing Physicians. Philadelphia: W.B. Saunders; 1963. Google Scholar14. Fiumara N. Treatment of primary and secondary syphilis. Serological response. JAMA. 1980;243:2500-2. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: Daniel M. 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