Metronidazole in human infections with syphilis.

Abstract

Six patients of the Pedi tribe (in Sekhukhuniland, Africa) with secondary syphilis were experimentally treated with metronidazole, a drug widely used in the treatment of trichomonal vaginitis, in the unusually high dosage of 13 to 30 g given over a period of 5 to 9 days. All of the patients showed healing of the syphilitic lesions between the 4 and 7 days, and all showed transient fever which was felt to be a modified Jarisch-Herxheimer reaction. Two of the patients became darkfield-negative by the 3rd day, two by the 4th and one on the 6th and one on the 8th. Serum concentrations of metronidazole varied from 15 to 72 fig/ml and 2 spinal fluid samples showed 80 and 58 ug. In patients given the usual dosage of 200 mg of metronidazole 3 times a day for 7 days, serum concentration varies from 3.6 to 9.8 ug/ml. This dosage schedule had no effect on the lesions of secondary syphilis.