Treatment of neurosyphilis. A comparison of penicillin regimens

Recommendations for treatment of neurosyphilis and reasons for renewed debate are briefly reviewed and discussed. Experience with 11 patients with neurosyphilis who were treated with different preparations of penicillin by different routes of administration is recorded. The concentration of penicillin was measured in the serum and cerebrospinal fluid in each case. Very high levels were attained by the intravenous administration of penicillin G, but in the follow-up period of 1 year this has not been shown to confer any advantage. The administration of procaine penicillin 1.2 million U intramuscularly daily for 20 days is as effective as a dosage schedule which requires admission to hospital for intravenous administration.