Inadequate or suboptimal treatment of maternal syphilis

Inadequate therapy

Treatment with a nonpenicillin antibiotic

Treatment less than four weeks before delivery (including treatment with penicillin)

Inappropriate dose for stage of disease

Inadequate documentation of maternal treatment

Lack of performance of serial non-treponemal* antibody titers after maternal treatment

Maternal therapy was not documented

Inadequate response to therapy

Maternal non-treponemal antibody titers did not decline at least fourfold (two dilutions) after treatment

Maternal non-treponemal antibody titers suggest reinfection or relapse (ie, fourfold increase)

* Non-treponemal test: Rapid plasma reagin (RPR) test or Venereal Disease Research Laboratory (VDRL) test.

References:

Centers for Disease Control and Prevention. Syphilis (Treponema pallidum) 2018 Case Definition. https://ndc.services.cdc.gov/case-definitions/syphilis-2018/ (Accessed on June 17, 2021).
American Academy of Pediatrics. Syphilis. In: Red Book: 2021-2024 Report of the Committee on Infectious Diseases, 32nd ed, Kimberlin DW, Barnett ED, Lynfield R, Sawyer MH (Eds), American Academy of Pediatrics, Itasca, IL 2021. p.729.
Workowski KA, Bolan GA. Sexually Transmitted Diseases Treatment Guidelines, 2015. MMWR Recomm Rep 2015; 64:1.

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