title: Audit of the management of early syphilis at North Manchester General Hospital.
abstract: The city of Manchester has seen a sustained increase in reported cases of early (infectious) syphilis since the late 1990s. We audited the management of patients presenting with early syphilis to North Manchester General Hospital, with reference to the UK national guidelines. Between January 1999 and December 2001 72 cases of early syphilis were identified. Most (90%) occurred in men who have sex with men, 50% of whom were HIV-positive. Serology and polymerase chain reaction testing of lesions were useful diagnostic tests. Treatment regimens followed the national guidelines in 63% of cases, with adherence to the guidelines improving as the outbreak continued. The majority of patients were treated with intramuscular penicillin (78%), with only three discontinuing this treatment due to side effects. Only 4% of sexual contacts identified were traced and screened, an indication of high levels of both anonymous sex and partner change in this group.
authors.affiliation: Department of Genitourinary Medicine, North Manchester General Hospital, Delaunays Road, Crumpsall, Manchester M8 5RB, UK.
authors.forename: M A
authors.initials: MA
authors.lastname: Kingston
authors.forename: S P
authors.initials: SP
authors.lastname: Higgins
mesh_terms: D000284:Administration, Oral; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002690:Chlamydia Infections / Q000453:epidemiology; D016358:Contact Tracing / Q000706:statistics & numerical data; D004318:Doxycycline / Q000627:therapeutic use; D005260:Female; D019983:Guideline Adherence; D015658:HIV Infections / Q000453:epidemiology; D018451:Homosexuality, Male / Q000706:statistics & numerical data; D006801:Humans; D007273:Injections, Intramuscular; D008297:Male; D008403:Mass Screening / Q000706:statistics & numerical data; D008485:Medical Audit; D010402:Penicillin G Procaine / Q000627:therapeutic use; D012189:Retrospective Studies; D013587:Syphilis / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology; D006113:United Kingdom / Q000453:epidemiology
chemical_list: D000900:Anti-Bacterial Agents; D010402:Penicillin G Procaine; D004318:Doxycycline