The Importance of Same-Day Nontreponemal Testing when Treating Syphilis

In a retrospective study, 12% of patients (particularly those with primary and secondary syphilis) had a 4-fold increase in RPR titer between initial diagnosis and time of treatment.

After the diagnosis of syphilis is established with nontreponemal testing (rapid plasma reagin [RPR] or venereal disease research laboratory [VDRL]), repeating these tests at treatment has been recommended out of concern that an increase in titer may have occurred between initial testing and the day of treatment. If such an increase had happened, failure of therapy could be suggested at subsequent follow-up in the absence of a four-fold decline relative to the initial titer. Is this practice warranted? Investigators performed a retrospective cohort study using data from 766 adults during their initial presentation of syphilis at the Melbourne Sexual Health Centre in Australia between March 2011 and December 2020.

Median time between initial …

Reviewing Author

Neil M. Ampel, MD

Disclosures

Editorial BoardsUpToDate

Leadership Positions in Professional SocietiesCoccidioidomycosis Study Group (Past President, Secretary, Treasurer)

Neil M. Ampel, MD

Disclosures

Editorial BoardsUpToDate

Leadership Positions in Professional SocietiesCoccidioidomycosis Study Group (Past President, Secretary, Treasurer)

The Importance of Same-Day Nontreponemal Testing when Treating Syphilis

Topics

Reviewing Author