Page 97 - Demo

Syphilis Treatment Options%u2022 Key Points:%u2022 Penicillin remains the drug of choice for all stages of syphilis. %u2022 Patients allergic to penicillin should be desensitized if possible, especially in pregnancy or neurosyphilis. %u2022 Follow-up serological tests are crucial to ensure treatment success. %u2022 Sexual partners should be notified and treated if exposed within the past 90 days. %u2022 HIV co-infection may require longer treatment durations and closer follow-up. Stage of Syphilis First-line Treatment Alternative Treatment DurationPrimary, Secondary, or Early Latent (<1 year) Benzathine Penicillin G 2.4 million units IM Doxycycline 100 mg orally twice daily OR Tetracycline 500 mg orally four times dailySingle dose for Penicillin; 14 days for alternativesLate Latent (>1 year) or Latent of Unknown DurationBenzathine Penicillin G 2.4 million units IM Doxycycline 100 mg orally twice daily OR Tetracycline 500 mg orally four times dailyOnce weekly for 3 weeks for Penicillin; 28 days for alternativesNeurosyphilis Aqueous Crystalline Penicillin G 18-24 million units IV dailyProcaine Penicillin 2.4 million units IM daily PLUS Probenecid 500 mg orally four times daily10-14 daysCongenital SyphilisAqueous Crystalline Penicillin G 50,000 units/kg IV every 12 hours (first 7 days of life) or every 8 hours (after 7 days of life)Procaine Penicillin G 50,000 units/kg IM daily 10 daysSyphilis in Pregnancy Benzathine Penicillin G 2.4 million units IM Desensitization to penicillin and then treat with penicillinSingle dose (may need to repeat depending on stage)