To the Editor Dr Clement and colleagues1 reviewed the available literature on treatment for the early and late stages of syphilis and concluded that benzathine penicillin G is the established treatment for early syphilis (grade A level of evidence). Scarce data are available on treatment of more advanced stages, such as neurosyphilis. Intravenous administration of penicillin G achieves adequate cerebrospinal fluid (CSF) levels and is currently the treatment of choice for neurosyphilis. We noticed that the role of an old drug, probenecid, was hardly mentioned in the review, although it could have a role in treating neurosyphilis.
van Brussel ASA, Landman GWD. Treatment of Late-Stage Syphilis. JAMA. 2015;313(9):968-969. doi:10.1001/jama.2015.0669