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 37<br />
If a syphilis diseased patient has Gonorrhoea, Chlamydia infection or other genitourinary<br />
infections, then treatment is done together with syphilis treatment.<br />
If a patient occurred HIV-positive, then he is to be sent to a regional AIDS prevention <strong>and</strong><br />
treatment centre <strong>for</strong> further diagnostic, treatment <strong>and</strong> permanent examination at the same time<br />
following the syphilis treatment recommendations as well.<br />
7. Treatment <strong>of</strong> patients with tertiary <strong>and</strong> late latent syphilis<br />
Treatment <strong>of</strong> patient with tertiary syphilis <strong>and</strong> associated specific damage <strong>of</strong> inner organs is done<br />
in the same way as visceral treatment. In cases <strong>of</strong> late latent syphilis as well as having no visceral<br />
damage a patient goes through treatment according to the following methods:<br />
Method 1<br />
Water soluble penicillin in 1 million units dose 4 times a day, within 28 days. Then, after two<br />
weeks interval, the second treatment course is done either in the same way or with a moderate<br />
durability penicillin preparation. The second course lasts 14 days.<br />
Method 2<br />
Treatment is done with novocaine penicillin salt in 600 000 units dose two times a day, within 28<br />
days.<br />
After two weeks interval the second course in the same doses is prescribed. It lasts two weeks.<br />
Besides, procaine penicillin can be used, applied once a day, within 20 days. The second course<br />
in the same doses is applied after two weeks interval. It lasts 10 days.<br />
8. Treatment <strong>of</strong> patients with late visceral neurosyphilis<br />
A. Treatment <strong>of</strong> patients with late visceral neurosyphlis<br />
The treatment is conducted by a dermatoveneorologist together with an internist, who prescribes<br />
accompanying <strong>and</strong> symptomatic therapy.<br />
Method 1<br />
Treatment starts with two weeks <strong>of</strong> preliminary treatment with general antibiotics (tetracycline,<br />
erythromycin) by 0.5 grams 4 times a day. Then penicillin therapy starts. Penicillin is taken<br />
intramuscular in 400 000 units doses 8 times a day within 28 days.<br />
The second course <strong>of</strong> penicillin treatment in the same doses is prescribed after two weeks<br />
interval.<br />
Method 2<br />
Treatment is done in the same way as it was described in the previous method, but instead <strong>of</strong><br />
soluble penicillin novocaine penicillin salt is used in a dose 600000 units 2 times a day.<br />
Treatment can be also done by procaine penicillin in 1.2 million units doses once a day. Duration<br />
<strong>of</strong> the first course <strong>of</strong> treatment is 42 days, the second is 14 days.<br />
B. Treatment <strong>of</strong> patients with late neurosyphilis<br />
Treatment <strong>of</strong> patients with late neurosyphilis (a progressive paralysis, tabes dorsalis) is done by<br />
the same methods recommended <strong>for</strong> treatment <strong>of</strong> patients having early neurosyphilis. Distinction