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Syphilis

Syphilis Possible therapeutic alternatives
Syphilis (early)
Less than one year. Primary: ulcer or chancre at site of infection. Secondary: rash, mucocutaneous lesions, adenopathy.
T. pallidum
Benzathine Penicillin G   2.4mu IM x 1 (if pregnant-repeat therapy after 1 week).
Alternatives:
Ceftriaxone 1 gram IV/IM q24h x 10 - 14 days OR
Doxycycline 100mg twice daily for 2 weeks  OR
Azithromycin 2000mg x 1 OR
Tetracycline 500mg four times daily for 2 weeks
Syphilis (late, or greater than one year duration) Tertiary (late): cardiac, neurologic, ophthalmic, auditory or gummatous lesions. T. pallidum
Benzathine Penicillin G 2.4 million units IM weekly x 3 doses
Penicillin allergic patients
Doxycycline 100mg twice daily for 28 days
or
tetracycline
500mg orally four times daily for 28 days. 
Neurosyphilis T. pallidum
Penicillin G  3 to 4 million units q4h IV for 10-14 days or 
Procaine penicillin 2.4 million units IM qd, +  probenecid 500 mg PO qid x 10-14 days
Ampicillin 4 grams IVPB every 6 hours for 10 to 14 days. // Desensitize penicillin allergic patients.

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Secondary Syphilis

References - Infectious Disease Section

Infectious Disease References

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The authors make no claims of the accuracy of the information contained herein; and these suggested doses are not a substitute for clinical judgement. Neither GlobalRPh Inc. nor any other party involved in the preparation of this program shall be liable for any special, consequential, or exemplary damages resulting in whole or part from any user's use of or reliance upon this material.
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