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

EUR/03/5045931
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Treponema Pallidum Immobilization test, FTAabs) should be done. If then Treponema Pallidum
Immobillisation test or FTAabs are negative and clinical investigation haven’t revealed
pathologic changes then test should be repeated at the age of one year, before getting the child
removed from the registration.
If at the age of three months any pathology or positive serological tests have been revealed then
test should be repeated in six months at the age of one year.
Children received specific treatment concerning both early and late congenital syphilis should go
through clinical serological control following the same principal as the adults concerning their
early and late forms of acquired syphilis, accordingly. But this is prescribed only after a child is
over one year old.
Children received treatment concerning the acquired syphilis, go through clinical serology
control carry out in the same way as the adults.
In case of clinical or serological relapse patients are subject to inspection of therapist,
neuropathologist, oculist, otolaryngologist; besides it is expedient to make a spinal puncture. The
treatment is carried out following the techniques stipulated for secondary and latent syphilis,
with prescription over six months.
13. Serofast (Seroresistance) and additional treatment
Seroresistance is a stable WR (or RPR) positivity preservation after full treatment concerning
early stages of syphilis. Serofast (Seroresistance) appears when within one year after the
termination of the therapy WR results with treponemal and cardiolipine antigenes or RPR results
remain steady positive without the tendency to decrease in reagines titres. In these cases
additional treatment is prescribed.
If one year later full treatment WR (or RPR) negativation doesn’t occur, but reagines titres
decrease (at least four times), or Compliment Bounding Reaction (WR) positivity degree
decreases from sharply positive up to poorly positive than these cases are considered as the
inhibition of seroreactions conversion is marked, and supervision is continued for six more
months. If during this period the Compliment Bounding Reaction (WR) positivity still decreases
then supervision can be continued for six more months. In case of no further decrease of
Compliment Bounding Reaction positivity additional treatment is prescribed. Thus, additional
and, as a rule, unitary treatment is carried out in view of CSR dynamics in the terms of 1–2 years
after the first treatment.
Additional treatment should be carried out following the techniques providing high enough level
of an antibiotic concentration in a body. Therefore application of soluble penicillin and average
lasting preparations is preferable.
Method 1
Treatment is carried out in a hospital by soluble penicillin in a doze 1 million. units 6 times a day
within 20 days.
Method 2
Treatment is on an outpatient basis with procaine penicillin 1.2 million units once a day within
20 days or with novocaine of penicillin 600 000 units, twice a day within 20 days.