Epidemiologic treatment of syphilis.

Epidemiologic treatment refers to antibiotics administered when a diagnosis is considered likely on clinical, laboratory, or epidemiologic grounds, but before the results of confirmatory laboratory tests are known. This treatment is justified on the grounds that the potenial benefits of treating the patient outweigh the potential harm of not treating. This potential harm may affect the individual or the community. Individual sequelae are most significnat when congenital syphilis is allowed to develop due to delays in treating the pregnant woman or newborn child. Community sequelae occur when an infected patient disseminates disease during the interval between initial presentation and final diagnosis. Unless qualified by time limitation and the behavioral and disease characteristics of a given population, exposure to syphilis is a poor criterion for epidemiologic treatment. The risk of infection of certain groups (defined by epidemiologic, clinical, or serologic criteria) should be determined empirically so that epidemiologic treatment is only provided to groups in which this risk has been estimated.