Syphilis management in St. Petersburg, Russia: 1995-2001.
OBJECTIVE
The objectives of this study were to describe the recent syphilis epidemic in St. Petersburg, Russia; and to document the syphilis management practices in Russia to help inform the best way forward for a system in transition.


METHODS
This study was a retrospective cohort study of syphilis diagnosed and followed in St. Petersburg, 1995-2001.


RESULTS
A total of 1,024 persons were identified with syphilis. Persons treated for secondary syphilis with 400,000 IU aqueous penicillin intramuscularly every 3 hours for 28 days or 2.4 micro benzathine penicillin intramuscularly weekly for 2 weeks responded most rapidly. Persons treated with 1.5 micro bicillin-5 intramuscularly at diagnosis and then two times per week for 3 weeks or 2.4 micro bicillin-1 intramuscularly weekly for 3 weeks displayed sluggish responses (P<0.0001). Regimens for treating later stages revealed similar responses (P=0.21). Benzathine penicillin at a dosage of 2.4 micro intramuscularly weekly for 3 weeks was not a used regimen.


CONCLUSIONS
Benzathine penicillin at a dosage of 2.4 mu intramuscularly weekly for 1 to 2 weeks is in moderate use but its use should increase; 2.4 mu benzathine penicillin intramuscularly weekly for 3 weeks should be introduced as the standard of care for late syphilis. The efficacy of the locally manufactured bicillin-1 and bicillin-5 is in question.
Department of Dermatology and Venereal Diseases, Pavlov State Medical University, St. Petersburg, Russia.
Andrew
A
Yakubovsky
Eugene
E
Sokolovsky
William C
WC
Miller
P Frederick
PF
Sparling
Robert W
RW
Ryder
Irving F
IF
Hoffman
D000328:Adult; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D015331:Cohort Studies; D004196:Disease Outbreaks; D018562:Disease Transmission, Infectious / Q000517:prevention & control; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007273:Injections, Intramuscular; D008297:Male; D008499:Medical Records; D010401:Penicillin G Benzathine / Q000008:administration & dosage; D010406:Penicillins / Q000008:administration & dosage; D012189:Retrospective Studies; D012426:Russia / Q000453:epidemiology; D013587:Syphilis / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control* / Q000635:transmission; D016896:Treatment Outcome; D019037:Urban Health Services
D000900:Anti-Bacterial Agents; D010406:Penicillins; D010401:Penicillin G Benzathine