Treatment Recommendations for Syphilis in Non-Pregnant ...
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Treatment Recommendations for Syphilis in Non-Pregnant Adults by Syphilis Stage



Incubating Infection, Primary, Secondary, Early Latent Syphilis:

 • Benzathine penicillin G 2.4 million units as a single intramuscular injection

  Alternatives Regimens (for nonpregnant patients with a documented penicillin allergy)

   • Oral doxycycline 100mg twice daily for 14 days

   • Oral tetracycline 500mg 4 times each day for 14 days

Late Latent or Latent Syphilis of Unknown Duration:

 • Benzathine penicillin G 7.2 million units total, administered as 3 separate doses of 2.4 million units intramuscuarly, each at 1-week intervals

  Alternative Regimens (for nonpregnant patients with a documented penicillin allergy)

    • Oral doxycycline 100mg twice daily for 28 days

    • Oral tetracycline 500mg 4 times daily for 28 days

Neurosyphilis or Ocular/Otic Syphilis

 • Aqueous crystalline penicillin G 18-24 million units per day, administered as 3-4 million units intravenously every 4 hours, or by continuous infusion, for 10-14 days

  Alternative Regimen

    • Procaine penicillin G 2.4 million units intramuscularly once daily for 10-14 days

  PLUS

    • Probenecid 500mg orally 4 times daily for 10-14 days

Tertiary syphilis should be managed in consultation with an infectious disease specialist. Testing for HIV infection and CSF examination should be performed before therapy is initiated.



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Contributed by

Dr. Gerald Diaz
@GeraldMD
Board Certified Internal Medicine Hospitalist, GrepMed Editor in Chief 🇵🇭 🇺🇸 - Sign up for an account to like, bookmark and upload images to contribute to our community platform. Follow us on IG:  https://www.instagram.com/grepmed/ | Twitter: https://twitter.com/grepmeded/
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