Benzathine Penicillin in the Management of the Treponematoses

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Abstract
The long-acting characteristics of procaine penicillin G in oil with 2% aluminum monostearate (PAM) are compared with those of benzathine penicillin G. Clinical trials indicate that the same curative effect can be obtained in early treponemal infections with a single injection of benzathine penicillin half that of PAM. Preventive treatment on epidemiological indications is an established principle in the effective management of the non-venereal, endemic treponematoses. In some countries such procedures have also been introduced in the management of veneral syphilis and gonorrhea. The superior preventive effect of benzathine penicillin, as compared with PAM, was demonstrated in individuals exposed to contagion and in individuals incubating the treponematoses. The sensitizing potential of penicillin is low, but previous treatment with the antibiotic, repeated application in prolonged treatment schedules, and possibly the use of large dosages, tends to increase the incidence of reactions. Use of benzathine penicillin will further limit the incidence of sensitization reactions, since lower dosages make one-session treatment schedules a practical proposition. In some countries, benzathine penicillin G is already replacing PAM in clinical practice in the management of syphilis and gonorrhea.