An audit of patients treated for syphilis at Auckland Sexual Health Service.

AIM: As there is no New Zealand data, an audit of patients treated for syphilis at Auckland Sexual Health Service (ASHS) was undertaken to see if management conformed to guidelines and was achieving acceptable outcomes.

METHODS

Cases were initially identified from laboratory data and were categorised as being either infectious or non-infectious according to clinical and laboratory criteria. Management was compared to recommendations from ASHS treatment guidelines and treatment outcome was assessed by serological response.

RESULTS

109 cases of syphilis were identified including 9 with HIV infection (8%). Men who had sex with men were much more likely to be diagnosed with infectious syphilis than heterosexuals (p<0.0001). Fifty-one percent of infectious cases (n=35) were asymptomatic. Ninety-four percent (n=103) of cases were treated with antibiotic regimens appropriate for their clinical stage. Discrepancy in management occurred most often in the early latent and unknown duration categories. Ninety-eight cases (90%) completed the full 12 months serological follow-up period and 97% (n=92) of those had an adequate serological response to treatment. There were no treatment failures in patients with HIV infection.

CONCLUSION

Current care of patients with syphilis at Auckland Sexual Health Service is achieving acceptable outcomes. Criteria for diagnosing infectious syphilis cases need to be standardised as it has implications for management and disease surveillance. MSM are a major risk group for acquisition of infectious syphilis and regular serological screening is recommended as a large proportion will be asymptomatic.