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Probenecid in the treatment of neurosyphilis in men who have sex with men: a commentary
  1. Daniel Richardson1,2,
  2. David Goldmeier3,4
  1. 1Sexual health and contraception / The Lawson unit, University Hospitals Sussex NHS Foundation Trust, Brighton, UK
  2. 2Brighton and Sussex Medical School, Brighton, UK
  3. 3Jefferiss Wing, St. Mary's Hospital, Imperial College Healthcare NHS Trust, London, UK
  4. 4Imperial College of Medicine, London, UK
  1. Correspondence to Dr Daniel Richardson, University Hospitals Sussex NHS Foundation Trust, Brighton, BN2 5BE, UK; docdanielr{at}

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Probenecid is a uricosuric drug, which inhibits the renal excretion of procaine penicillin via inhibition of the organic anion transporter (OAT-1) system in the proximal renal tubule producing higher plasma and cerebrospinal fluid (CSF) penicillin levels.1 2 Oral probenecid is recommended to be used with intramuscular procaine penicillin for the treatment of neurosyphilis.

Rates of syphilis and neurosyphilis have increased significantly over the past 20 years particularly in men who have sex with men (MSM). There …

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  • Contributors DR came up with the concept and produced the first draft, DR and DG worked together to produce the final manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; internally peer reviewed.

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