Objectives: 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.
Design: 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 μ benzathine penicillin intramuscularly weekly for 2 weeks responded most rapidly. Persons treated with 1.5 μ bicillin-5 intramuscularly at diagnosis and then two times per week for 3 weeks or 2.4 μ 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 μ intramuscularly weekly for 3 weeks was not a used regimen.
Conclusion: Benzathine penicillin at a dosage of 2.4 μ intramuscularly weekly for 1 to 2 weeks is in moderate use but its use should increase; 2.4 μ 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.