Neurosyphilis and penicillin levels in cerebrospinal fluid

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Abstract
Because neurosyphilis may progress despite therapy with the recommended pencillin regimens, 15 subjects with positive tests for syphilis in the serum and CSF were studied. All of these patients had CSF pleocytosis. Two received pencillin G (5 and 10 .times. 106 units/day i.v., respectively) and 13 received benzathine penicillin G, 3.6 .times. 106 units/wk i.m.; treatment lasted 4 wk. During i.v. and after i.m. penicillin therapy, a spinal tap was performed on all subjects; later, assays were done. Of 2 patients who received i.v. penicillin G, 1 had 0.3 .mu.g/ml and the other had 2.4 .mu.g/ml penicillin in the CSF. Twelve of 13 patients who received benzathine penicillin G had no detectable penicillin in the CSF; 1 patient had 0.1 .mu.g/ml penicillin in the CSF.

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