Erroneous treatment of syphilis with benzyl penicillin in an era with benzathine benzylpenicillin shortages

Syphilis in Greenland, 2015 to 2019

“…Furthermore, a few cases were treated with single injections of regular benzylpenicillin instead of benzathine penicillin, a serious error easy to make for non–venerology-specialized healthcare professionals. 30 The treatment-related issues were primarily restricted to specific regions (data not shown), and the degree of follow-up also varied among the regions, which, in combination with regionally low total numbers of syphilis cases, indicate a need for a more uniform case handling through, for example, centralization. This suggestion is supported by the fact that the region with the absolute highest annual incidence, Sermersooq East, has managed to reduce incidence for the years 2017 to 2019 compared with 2015 to 2016, probably because of expertise acquired over time, focused efforts, and strict follow-up.…”

“…To our surprise, a large proportion of cases were treated with 2 injections of benzathine penicillin, which does not comply with guidelines for neither early nor late syphilis. Furthermore, a few cases were treated with single injections of regular benzylpenicillin instead of benzathine penicillin, a serious error easy to make for non–venerology-specialized healthcare professionals 30 . The treatment-related issues were primarily restricted to specific regions (data not shown), and the degree of follow-up also varied among the regions, which, in combination with regionally low total numbers of syphilis cases, indicate a need for a more uniform case handling through, for example, centralization.…”

Update on syphilis in pregnancy: marrying basic science advances and clinical perseverance to solve an ancient public health problem

“…Erroneous treatment of syphilis with the shortacting benzyl penicillin [21] has been reported as a direct consequence of benzathine penicillin G shortages. In an ecological study by Ureles Braga et al [22], benzathine penicillin G shortage was associated with a 2.17-fold increase in the risk of ] provides some of the first in vitro evidence for T. pallidum antimicrobial sensitivities, and this work may be foundational for future studies in humans to find reasonable alternatives to benzathine penicillin G for treatment of syphilis in both pregnant and nonpregnant individuals.…”

Spatial mapping of gonorrhoea notifications by sexual practice in Victoria, Australia, 2017–2019

“…Furthermore, injectable treatments for gonorrhoea and syphilis -ceftriaxone and benzathine penicillin -need to be available to practitioners in these areas together with correct treatment and effective partner management. 9 © 2021 The Authors Letter…”