European and National guidelines stipulate patients with early syphilis should attend for clinical and serological follow-up at 1, 2, 3, 6 and 12 months post-treatment.1 2 Serological follow-up uses the non-treponemal antigen tests—for example, Venereal Disease Research Laboratory (VDRL)—to monitor treatment response and identify if re-infection or treatment failure has occurred. To date, there has been no evidence outlining the need for serological follow-up before 3 months. The Centers for Disease Control and Prevention (CDC) guidelines stipulate follow-up at 6 and 12 months only.3

Clinical follow-up for early syphilis should ensure symptom resolution, compliance with treatment and abstinence from sex coordinated with partner notification/treatment. Similar follow-up for infections such as chlamydia …