A multi-district audit of the management of syphilis in genitourinary medicine clinics in Yorkshire.

An audit against standards and guidelines of a representative sample of syphilis cases managed in genitourinary medicine clinics in Yorkshire was carried out. Satisfactory serological endpoints could be determined for about two-thirds of treated early and less than one-third of treated late syphilis cases. HIV antibody testing was obtained for less than half of all cases. Recently available national guidelines suggest inadequacy of both the dose and duration of treatments with procaine penicillin of asymptomatic late syphilis cases where lumbar puncture was not carried out. The diagnosis and management of syphilis is complex, and this audit demonstrates the importance of the systematic approach developed by genitourinary medicine clinic and laboratory services.