Persistence of treponemes after treatment.

Dunlop, E. M. C.

doi:10.1136/bmj.2.5813.577

Cited by 19 publications

(2 citation statements)

References 73 publications

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“…Замедление или отсутствие негативации серологических реакций зарубежные эксперты склонны рассматривать как индивидуальную особенность пациентов, а не неудачу терапии [11]. Более того, дискутируется даже клиническая значимость персистенции в организме бледных трепонем после «адекватного» лечения, так как их вирулентность не доказана [9,[22][23][24].…”

Section: лечение больных ранними формами сифилисаunclassified

Current standards for syphilis treatment: comparing the russian and foreign guidelines (part II)

Krasnoselskikh

Sokolovskiy

Соколовский³

2015

Vestnik dermatologii i venerologii

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The introduction of penicillin has been a breakthrough in the treatment of syphilis. For 70 years, penicillin remains the preferred drug for the treatment of all forms of the disease; its effectiveness has been proven by wide experience gained from clinical observations. However, a very limited number of published meta-analyzes, systematic reviews and data from randomized controlled trials on the comparative assessment of the effectiveness of various antibiotics and treatment regimens are currently available. Some aspects of syphilis treatment are insufficiently developed, particularly, the treatment schedules for neurosyphilis, syphilis in pregnancy, syphilis in HIV-infected individuals and persons allergic to penicillin. There are disagreements in the assessment of the clinical significance of serofast state after a course of antibiotic therapy. There is no uniform approach to the management of patients with treatment failures. This article compares the Russian standards for syphilis treatment set out in the «Federal guidelines for the management of patients with syphilis» with the current European recommendations of the International Union against Sexually Transmitted Infections (IUSTI) and the recommendations of the US Centers for Disease Control and Prevention (CDC). The peculiarities of these guidelines, their strengths and shortcomings, as well as controversial issues of syphilis therapy are discussed. The differences between the domestic and foreign recommendations are more significant in the section concerning the treatment of syphilis than in the section of diagnosis.

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Section: лечение больных ранними формами сифилисаunclassified

Current standards for syphilis treatment: comparing the russian and foreign guidelines (part II)

Krasnoselskikh

Sokolovskiy

Соколовский³

2015

Vestnik dermatologii i venerologii

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“…Since then, more than 100 patients with similar findings have been described. 2 However, methodological problems have cast some aspersions on these reports. Nevertheless, certain trou¬ blesome questions are raised regard¬ ing the clinical significance of the persistence of T pallidum, the fre¬ quency of occurrence, as well as the implications in terms of overall rec¬ ommendations for the treatment of syphilis.…”

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confidence: 99%

Persistence of Treponema pallidum Following Penicillin G Therapy

Tramont¹

1976

JAMA

119

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Late Syphilitic Hearing Loss: A Diagnostic and Therapeutic Dilemma

Becker¹

1979

The Laryngoscope

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Cochleovestibular dysfunction may occur as the only manifestation of late syphilis. It may occur singly, in combination, and be unilateral or bilateral. A presumptive diagnosis may be made on the basis of excluding other known etiologies of inner ear dysfunction and on a positive serological test for syphilis. The combined experience of the author and a literature review suggests that a combination of penicillin and prednisone is the treatment of choice. Since no controlled clinical trials have been reported, antibiotic and corticosteroid dosage, timing and route of administration are conjectural. All patients with a presumptive diagnosis of late otitic syphilis should be treated regardless of previous syphilitic treatment. Duration of symptoms and magnitude of functional loss are not contraindications. Penicillin is the antibiotic of choice and the minimal treatment should be the United States Public Health Service schedule for late syphilis, i.e., benzathine penicillin G, 2.4 million units by intramuscular injection weekly for three successive weeks. Since penicillin acts on dividing cells only and since treponemes probably divide very slowly in late syphilis, prolonged penicillinemia is desirable. This may be maintained with injectable depo‐penicillin (benzathine penicillin G) or penicillin by mouth, depending upon patient compliance. Duration of treatment of one year is suggested. Prednisone, 40 to 60 mgm/day by mouth is started and continued for at least two weeks. If symptomatic improvement occurs the dose is tapered to a level which will maintain this improvement.

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Persistence of treponemes after treatment.

Cited by 19 publications

References 73 publications

Current standards for syphilis treatment: comparing the russian and foreign guidelines (part II)

Current standards for syphilis treatment: comparing the russian and foreign guidelines (part II)

Persistence of Treponema pallidum Following Penicillin G Therapy

Late Syphilitic Hearing Loss: A Diagnostic and Therapeutic Dilemma

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