January 31, 1972

Treatment of Choice for Uncomplicated Gonorrhea

JAMA. 1972;219(5):620. doi:10.1001/jama.1972.03190310045016

To the Editor.—  In the therapy of "uncomplicated" gonorrhea, one of our main tasks must be to exclude coexisting syphilis. In regards to permanent morbidity and disability, syphilis is still the greater venereal disease menace to the public health. The venereal disease research laboratory (VDRL) test, the commonest screening test for syphilis, has been proved to be insensitive in the detection of either incubating or early primary syphilis. If tetracycline is dispensed, then for adequate syphilis detection and prevention, the patient must return at least once during the three-month maximal incubation period of syphilis for repeat VDRL testing. When the patient is relieved of his gonorrhea symptoms, he often will not voluntarily return for such testing, thus introducing a gap in this means of syphilis control. Procaine penicillin G, on the other hand, in gonorrhea treatment doses has proved effective in aborting preclinical syphilis, and repeated VDRL testing, therefore, becomes