| 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. |
|
