Review of Current Evidence and Comparison of Guidelines for ...
Review of Current Evidence and Comparison of Guidelines for ...
Review of Current Evidence and Comparison of Guidelines for ...
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EUR/03/5045931<br />
page 36<br />
Method 3<br />
Treatment is done with procaine penicillin – 1.2 million units per injection daily, within 20 days,<br />
or with novocaine salt 600 000 units twice a day, within 20 days.<br />
Method 4<br />
Water soluble penicillin in 1 million units dose is injected every 6 hours (4 times a day) within<br />
20 days.<br />
Note: Mostly the third <strong>and</strong> the fourth methods are prescribed <strong>for</strong> patients with “late” relapse,<br />
with alopecia <strong>and</strong> white spots, as well as <strong>for</strong> patients with early latent syphilis with over six<br />
months duration <strong>of</strong> the disease.<br />
4. Treatment <strong>of</strong> patients with early visceral neurosyphilis<br />
Patients with early visceral neurosyphilis should get treatment in an inpatient clinic being<br />
supervised by a clinician.<br />
Method 1<br />
Specific treatment is done with soluble penicillin, 1 million units per injection, taken 4 times a<br />
day within 20 days.<br />
Method 2<br />
Novocaine penicillin salt 600 000 units twice a day during 20 days. In all the cases symptomatic<br />
therapy is prescribed.<br />
5. Treatment <strong>of</strong> patients with early neurosyphilis.<br />
The decision about hospitalization <strong>of</strong> a patient with early neurosyphilis is usually undertaken by<br />
neuropathologist <strong>and</strong> dermatovenereologist on a base <strong>of</strong> severity <strong>of</strong> disease <strong>and</strong> localization <strong>of</strong><br />
pathology.<br />
Method 1<br />
Intravenous dropper with benzylpenicillin sodium salt in 10 million dose twice a day within 14<br />
days is prescribed. One dose <strong>of</strong> the antibiotic is dissolved in 400 ml <strong>of</strong> NaCl isotonic solution<br />
<strong>and</strong> applied intravenously within 1.5–2 hours. The solutions are to be used immediately after<br />
being prepared.<br />
Method 2<br />
Soluble penicillin (sodium) in 2 million units dose 6 times a day within 14 days is injected<br />
intravenously. One penicillin dose is dissolved in 10 ml <strong>of</strong> saline <strong>and</strong> is injected slowly, <strong>for</strong> 3–5<br />
minutes, into elbow vein.<br />
The decision about preventive <strong>and</strong> symptomatic treatment is discussed by consulting with<br />
dermatoveneorologist, neuropathologist, <strong>and</strong> if necessary with oculist. In six months after the<br />
treatment a control CSF test should be done. If the sanitation is absent, then treatment course<br />
should be repeated.<br />
6. Principles <strong>of</strong> treatment <strong>of</strong> syphilis infected patients with associated STI diseases.<br />
Syphilis infected patients must go through HIV <strong>and</strong> STI tests.
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