Recommendations
| Дозування | Ремарки | |
|---|---|---|
|
benzathine benzylpenicillin intramuscular 2.4 million IU single dose
|
SWAB remarks Stage 1, 2 and early latent syphilis |
|
|
benzathine benzylpenicillin intramuscular 2.4 million IU once weekly for 3 weeks
|
SWAB remarks late latent syphilis or latent syphilis of unknown duration, tertiary syphilis and pregnant women |
|
|
benzylpenicillin IV 3 million IU six times daily for 10 to 14 days
or benzylpenicillin IV loading dose 3 million IU, 18 million IU continuous over 24 hours for 10 to 14 days |
SWAB remarks neurosyphilis and ocular syphilis |
| Дозування | Ремарки | |
|---|---|---|
|
doxycycline oral 100 mg twice daily for 2 weeks
|
SWAB remarks Stage 1, 2 and early latent syphilis |
|
|
doxycycline oral 100 mg twice daily for 4 weeks
|
SWAB remarks late latent syphilis or latent syphilis of unknown duration |
Penidural: possibly dissolve 1.2 mE in 2 cc lidocaine 20 mg/ml + 2 cc saline, into each buttock
If in neurosyphilis/ocular syphilis there is a possible IgE-mediated penicillin allergy, penicillin desensitisation followed by treatment with short-acting benzylpenicillin IV should be considered.
For non-IgE-mediated allergy, ceftriaxone 2 grams IV for 14 days can be given as an alternative.
Pregnant women with a penicillin allergy should preferably be treated with (benzathine benzyl)penicillin, if necessary after desensitisation.
An alternative that can be given on an outpatient basis for neuro/ocular syphilis is ceftriaxone 2 grams IV, once daily, for 14 days, but this is not the first choice.