Review of Current Evidence and Comparison of Guidelines for ...

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Annex 2. UK National Guidelines on the Management of Early Syphilis ............. 29 Annex 3. UK National Guidelines on the Management of Late Syphilis.............. 30 Annex 4. Centers for Disease Control and Prevention, Sexually Transmitted Diseases Treatment Guidelines 2002............................................................. 31 Annex 5. Akovbian V, Filatova E. Management of Syphilis Infected Patients in Russia. Country Background Paper, May 2003 (Original in Russian, translated in English) ................................................................................... 32
Foreword EUR/03/5045931 page i “Come now, what regimen, what cure must be adopted to combat this great plague and what is appropriate at which stage of the illness I shall disclose and I shall expound the wonderful discoveries of men.” Girolamo Frascastoro’s Syphilis 1530 (1) This technical document reviews and compares syphilis treatment guidelines from Europe, the United Kingdom, the United States and Russian Federation. The guidelines and recommended treatment regimens differ somewhat from one guideline to another even though they are largely drawn from the same evidence. The Russian Federation guidelines, however, differ considerably from the other three guidelines in that they are based more on Russian experience and locally manufactured penicillin formulations; where they recommend imported drugs, the recommended doses or duration of therapy tend to exceed those in the other guidelines. The difference between guidelines from Russian Federation and those from elsewhere is explained, in part, by the “historical aspect” of syphilis management in this region. Syphilis management in Russian Federation has been of special “interest” to many physicians, almost mythical to others. Changes in policies for syphilis management are still ongoing in the Commonwealth of Independent States (e.g. inpatient versus outpatient management; dermatovenereologists versus primary health care concepts; locally manufactured drugs versus imported ones; cost and quality aspects, etc.). Future guidelines will undoubtedly show further evolution of thinking surrounding these and other issues. Treatment of syphilis has always been complex and confusing, having come with different recommendations in different guidelines for many years. There are areas of treatment where more data are needed. These areas need to be clearly identified so that appropriate research priorities can be defined and feasibility of such research established. There is an obvious need to harmonize syphilis treatment guidelines not only in Europe but globally, and this review contributes to the beginning of such a process. Francis Jim Ndowa (WHO HQ FCH/RHR/RTI)
Page 1 and 2: Review of Current Evidence and Comp
Page 3: CONTENTS Page Foreword ............
Page 8 and 9: EUR/03/5045931 page 2 addition ther
Page 10 and 11: EUR/03/5045931 page 4 differences i
Page 12 and 13: EUR/03/5045931 page 6 The CDC guide
Page 14 and 15: EUR/03/5045931 page 8 United Kingdo
Page 16 and 17: EUR/03/5045931 page 10 reports of t
Page 18 and 19: EUR/03/5045931 page 12 Acknowledgem
Page 20 and 21: EUR/03/5045931 page 14 32. Schofer
Page 22 and 23: EUR/03/5045931 page 16 70. Mohr J,
Page 24 and 25: EUR/03/5045931 page 18 110. Onoda Y
Page 26 and 27: EUR/03/5045931 page 20 Table 2a Ear
Page 28 and 29: EUR/03/5045931 page 22 Table 3 Late
Page 30 and 31: EUR/03/5045931 page 24 Table 5 Preg
Page 32 and 33: EUR/03/5045931 page 26 Table 7 Evid
Page 34 and 35: EUR/03/5045931 page 28 Annex 1 GOH
Page 36 and 37: EUR/03/5045931 page 30 Annex 3 UK N
Page 38 and 39: EUR/03/5045931 page 32 Annex 5 AKOV
Page 40 and 41: EUR/03/5045931 page 34 The period 1
Page 42 and 43: EUR/03/5045931 page 36 Method 3 Tre
Page 44 and 45: EUR/03/5045931 page 38 is that inst
Page 46 and 47: EUR/03/5045931 page 40 started the
Page 48 and 49: EUR/03/5045931 page 42 Treatment of
Page 50 and 51: EUR/03/5045931 page 44 Method 3 In
Page 52 and 53: EUR/03/5045931 page 46 HIV-positive
Page 54 and 55:
EUR/03/5045931 page 48 the latent s
Page 56 and 57:
EUR/03/5045931 page 50 15. Order No
Page 58 and 59:
EUR/03/5045931 page 52 Authors, yea
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