Treatment of cardiovascular syphilis

The English literature on the treatment of cardiovascular syphilis with penicillin was reviewed. To date there have been no controlled randomized clinical trials to demonstrate that penicillin therapy prolongs life expectancy, alleviates symptoms, or arrests the disease process. In spite of many shortcomings in the published data, penicillin is safe and free of severe reactions. Most authors agree that significant subjective improvement in the patient's status occurs following penicillin treatment. Once the patient has become symptomatic penicillin may have little efficacy. The optimal dosage and duration of therapy have never been established. Because of its low cost, ease of administration, and lack of toxicity, it should be given to all patients with cardiovascular syphilis in hope of arresting the effects of the disease on the heart and great vessels.