Development of an algorithm to facilitate the clinical management of syphilis.

BACKGROUND

Syphilis staging is important to determine treatment, post-treatment monitoring, and sexual partner follow-up. Many prescribers find syphilis staging to be challenging. Current guidelines for the management of patients diagnosed with syphilis provide little direction aside from an overview of some common symptoms and directing providers to stage cases in conjunction with experienced colleagues.

LOCAL PROBLEM

In Canada and the United States, the rate of infectious syphilis has increased noticeably since 2000. Given the increase in rates of syphilis, it is important for all clinicians to understand how to appropriately manage patient care to reduce rates of infection.

METHODS AND INTERVENTIONS

A clinical algorithm was developed to stage infectious syphilis. This was tested among nurse practitioners and physicians in a sexually transmitted infection clinic. The algorithm was developed based on a review of the available United States, Canadian, and British practice guidelines.

RESULTS

Project results demonstrated that this resource could be a relevant practice tool for providers in multiple clinical settings to ensure that patients receive appropriate diagnosis, staging, and treatment of syphilis infection. A case study of a patient who presented to the clinic as a contact is used to review the algorithm and demonstrate the appropriate clinical management of patients.

CONCLUSIONS

The algorithm appropriately guided practice and was useful to clinicians.