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P230 Review of syphilis management at a busy urban STI clinic
  1. Niamh Lynn,
  2. Padraig Calpin,
  3. Brendan O’Kelly,
  4. Ksenia Davenport,
  5. Fiona Lyons
  1. GUIDe Clinic, St. James’s Hospital, Dublin, Ireland


Background/introduction Appropriate management of syphilis is vital in order to avoid late complications. A retrospective cohort study of patients with positive serology at an urban STI clinic where the BASHH guidelines are followed was undertaken.

Aim(s)/objectives Evaluate: Documentation of syphilis stage, Treatment, Interval between treatment and first follow-up RPR, RPR 12 months post treatment - determine those with negative RPR; fourfold reduction in RPR or documented as “serofast”.

Methods A list of positive serology between April 2013 and March 2014 was generated. Patients managed at clinic were identified and their electronic record reviewed. Descriptive column statistics were used for data analysis.

Results 93 cases of syphilis were managed. Median age 35 years (range 20–74); 82 (88%) cases male; 47 (51%) HIV positive. Stage was documented in 45 (48%). Of those with undocumented stage, RPR >/=1:8 in 29, 25 were treated with single benzathine-penicillin. 85 received penicillin- based treatment, 48 (52%) received single dose benzathine penicillin. 8 received doxycycline. Median interval from treatment to subsequent RPR 40 days (range14- 219). 12 months post treatment, 48 (52%) had negative or “neat” RPR. 58 (62%) a fourfold reduction. In those with a positive RPR, 4 were deemed to be “serofast”.

Discussion/conclusion Syphilis continues to be a common infection in men. The majority of patients were treated with penicillin as per BASHH guidelines. There is room for improvement in documenting stage of infection and outcome in those who fail to have a fourfold reduction in RPR at 12 months.

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