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Failure of Erythromycin Estolate Therapy in In Utero Syphilis

Mary Ann South, MD; David H. Short, MD; John M. Knox, MD
JAMA. 1964;190(1):70-71. doi:10.1001/jama.1964.03070140076020.
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ERYTHROMYCIN is the most frequently administered antibiotic for the treatment of syphilis in patients with known penicillin allergy. Studies leading to current recommendations of optimum dosages of this drug in various stages of syphilis have been conducted in the Houston Social Hygiene Clinic, but its use during pregnancy has not yet been adequately evaluated. The observation of one patient in our study, who had a good serologic response to treatment with 15 gm of erythromycin estolate (Ilosone), but bore an infant who died of congenital syphilis, is the subject of this report.

Report of a Case  The mother, 16 years of age, gravida II, para I, in approximately the sixth month of pregnancy, had a perigenital, palmar, and plantar maculopapular rash. The clinical diagnosis, secondary syphilis, was supported by a Venereal Disease Research Laboratories slide test (flocculation test using the Atlantic VDRL's specific antigen) reactive at 64 dilutions.Because of


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