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In their commentary on the resurgence of syphilis in England, Fenton et al1 cover issues surrounding controlling outbreaks of syphilis, quoting parallels in the United States, and identify the need for simple treatment, preferably with a single dose regimen. Two important differences between the two countries in management strategy that could be relevant to the current UK situation are, however, not discussed. Firstly, variation in penicillin treatment regimen: in the United States single dose benzathine penicillin is recommended …