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

EUR/03/5045931
page 37
If a syphilis diseased patient has Gonorrhoea, Chlamydia infection or other genitourinary
infections, then treatment is done together with syphilis treatment.
If a patient occurred HIV-positive, then he is to be sent to a regional AIDS prevention and
treatment centre for further diagnostic, treatment and permanent examination at the same time
following the syphilis treatment recommendations as well.
7. Treatment of patients with tertiary and late latent syphilis
Treatment of patient with tertiary syphilis and associated specific damage of inner organs is done
in the same way as visceral treatment. In cases of late latent syphilis as well as having no visceral
damage a patient goes through treatment according to the following methods:
Method 1
Water soluble penicillin in 1 million units dose 4 times a day, within 28 days. Then, after two
weeks interval, the second treatment course is done either in the same way or with a moderate
durability penicillin preparation. The second course lasts 14 days.
Method 2
Treatment is done with novocaine penicillin salt in 600 000 units dose two times a day, within 28
days.
After two weeks interval the second course in the same doses is prescribed. It lasts two weeks.
Besides, procaine penicillin can be used, applied once a day, within 20 days. The second course
in the same doses is applied after two weeks interval. It lasts 10 days.
8. Treatment of patients with late visceral neurosyphilis
A. Treatment of patients with late visceral neurosyphlis
The treatment is conducted by a dermatoveneorologist together with an internist, who prescribes
accompanying and symptomatic therapy.
Method 1
Treatment starts with two weeks of preliminary treatment with general antibiotics (tetracycline,
erythromycin) by 0.5 grams 4 times a day. Then penicillin therapy starts. Penicillin is taken
intramuscular in 400 000 units doses 8 times a day within 28 days.
The second course of penicillin treatment in the same doses is prescribed after two weeks
interval.
Method 2
Treatment is done in the same way as it was described in the previous method, but instead of
soluble penicillin novocaine penicillin salt is used in a dose 600000 units 2 times a day.
Treatment can be also done by procaine penicillin in 1.2 million units doses once a day. Duration
of the first course of treatment is 42 days, the second is 14 days.
B. Treatment of patients with late neurosyphilis
Treatment of patients with late neurosyphilis (a progressive paralysis, tabes dorsalis) is done by
the same methods recommended for treatment of patients having early neurosyphilis. Distinction