The year 1943 saw the introduction, by Mahbney and his associates, of penicillin treatment for syphilis. That period was an epic turning point in many respects, not least of which was the commencement of the antibiotic era in venereology. From that point on, there were no antibiotics as effective, as cheap,or as low in toxicity as penicillin, despite the discovery of a number of other antibiotics. Also, no signs of resistance by Treponema pallidum to the antibiotic have yet been noted, although this possibility has not been evaluated adequately. Since then Benzathine penicillin G, a long acting Depo-penicillin, (discovered by Seifter, et al, in 1951), has been utilized for treating syphilis. After the discovery of penicillin, syphilis began to decline. However, during the middle 1950´s the incidence of syphilis began to increase throughout the world. In the 1960´s, this rate of increase became quite pronounced. Thus, the present trend is to treat most syphilis with Benzathine penicillin G. However, occasional adverse reactions, (e.g. hypersensitivity, anaphylactic shock, phobia of injections and other untoward effects), sometimes render treatment with Benzathine Penicillin G impossible. In such cases, treatment consists of the oral administration of Vibramycin^(®) (Doxycycline to compensate for the defects of the penicillin. Although the previous alternatives have traditionally been Tetracycline and Erythromycin, by utilizing Vibramycin, we are able to report the results comparing the effectiveness of Vibramycin with the effectiveness of Benzacillin. The results focus on clinical improvement and serological tests.
Thirty five patients were treated with Vibramycin, but despite our requests, only ten patients participated in the followup study. Among these ten patients, three patients were hypersensitive to penicillin. Forty nine patients were treated with Benzacillin, among which only thirteen patients responded to our follow-up studies. All members of the Benzacillin group were skin tested for penicillin hypersensitivity before treatment was initiated. Tkc Vibramycin treatment regimen was the oral administration of 200mg twice on the first day, and from the second day to the fourteenth day, 100nig twig daily.´ Three million units of Benzacillin were given intramuscalarly in weekly intervals for three weeks. The therapeutic results obtained were as follows: 1) The Vibramycin group showed remarkable clinical improvement on the third day of treatment, with clinical manifestations completely disappearing on the following days: Lymphangitis dorsalis penis, sixth day of treatment; headache ninth day, maculopapulo-squamous syphilids, eleventh day; condyloma lata, fourteenth day, primary chancre, tenth day after finishing treatment. However, regional lymphadenopathies persisted for over four and a half months. 2) In most patients, serological follow-up studies, (VDRL slide test, and Wassermann complement fixation test), revealed declining titers one month after concluding treatment. These titers continued to decline in the following months. One case of sero-relapse, however, was shown in both the Vibramycin group and the Benzacillin group. 3) No cases of side effects were observed in either treatment group. 4) It is concluded from this study that nine of ten patients (90%) in the Vibramycin group, and twelve ´of `hirteen patients (92.3%) in the Benzacillin group showed serological improvement.
Thus, in those instances where penicillin is contraindicated, (e.g. hypersensitivity, anaphylactic shock, etc.), Vibramycin (Doxycycline) appears to be one of the most valuable treatment alternatives available.
patients were hypersensitive to penicillin. Forty nine patients were treated with Benzacillin, among which only thirteen patients responded to our follow-up studies. All members of the Benzacillin group were skin tested for penicillin hypersensitivity before treatment was initiated. _ Tkc ´Vi&amycin treatment -regimen was_ AWl - oral administration of 200mg twice on the first day, and from the second day to the fourteenth day, 100nig twig daily.´ Three million units of Benzacillin were given intramuscalarly in weekly intervals for three weeks. The therapeutic results obtained were as follows: 1) The Vibramycin group showed remarkable clinical improvement on the third day of treatment, with clinical manifestations completely disappearing on the following days: Lymphangitis dorsalis penis, sixth day of treatment; headache ninth day, maculopapulo-squamous syphilids, eleventh day; condyloma lata, fourteenth day, primary chancre, tenth day after finishing treatment. However, regional lymphadenopathies persisted for over four and a half months. 2) In most patients, serological follow-up studies, (VDRL slide test, and Wassermann complement fixation test), revealed declining titers one month after concluding treatment. These titers continued to decline in the following months. One case of sero-relapse, however, was shown in both the Vibramycin group and the Benzacillin group. 3) No cases of side effects were observed in either treatment group. 4) It is concluded from this study that nine of ten patients (90%) in the Vibramycin group, and twelve ´of `hirteen patients (92.3%) in the Benzacillin group showed serological improvement.
Thus, in those instances where penicillin is contraindicated, (e.g. hypersensitivity, anaphylactic shock, etc.), Vibramycin (Doxycycline) appears to be one of the most valuable treatment alternatives available.
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