Erythromycin in early syphilis.

Keller and Morton (1953) first discovered the treponemicidal properties of erythromycin and Turner and Schaeffer (1954) showed that erythromycin came second to penicillin as the most active antibiotic against Treponema pallidum. Kolmer and Rule (1956) attributed treponemicidal properties to erythromycin, but obtained superior results with several other antibiotics. Alexander and Schoch (1954) treated four cases of early syphilis with erythromycin and observed the rapid disappearance of Treponema pallidum from the lesions, noting that the lesions healed as promptly as with other drugs. Montero (1956) treated 27 cases of early syphilis with erythromycin (9-12 g.) with satisfactory results, and Montgomery and Knox (1959) obtained encouraging results in forty cases using a similar dosage. Gertler (1961) treated twelve patients with early syphilis using 1-1-6 g. of erythromycin daily for 15-20 days (follow-up period 7 months) and concluded that erythromycin had a place in the treatment of those allergic to penicillin. Montgomery, Knox, Sciple, and Vanderstoep (1961) treated 148 cases of dark-field positive syphilis with different schedules of erythromycin, and concluded that 20 g. spread over 10 days might prove satisfactory, but that 10 g. over 10 days was not adequate and 9-10 g. over 3-S5 days was unsatisfactory. Greaves (1961) treated 29 cases of early syphilis and seventeen completed treatment and follow-up with a cerebrospinal fluid examination. He concluded that the results obtained with erythromycin were not comparable to those obtained with the usual dose of penicillin, but he used only a total dose of 10 g. in an 8-day course of treatment. Moore, Vander Stoep, Knox and Montgomery (1962) treated 130 dark-field positive cases of primary and secondary syphilis using three schedules of treatment, and found good results in those given 500 mg. three times a day for 10 days and 500 mg. 6-hrly for 10