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Available data demonstrate that use of additional doses of benzathine penicillin G, amoxicillin, or other antibiotics do not enhance efficacy of this recommended regimen when used to treat primary and secondary syphilis, regardless of HIV status (591–593).
Penicillin G, administered parenterally, is the preferred drug for treating patients in all stages of syphilis. The preparation used (i.e., benzathine, aqueous procaine, or aqueous crystalline), dosage, and length of treatment depend on the stage and clinical manifestations of the disease.
In adults and adolescents with early syphilis, the WHO STI guideline recommends benzathine penicillin G 2.4 million units once intramuscularly over no treatment. Strong recommendation, very low quality evidence.
Uses: For the treatment of primary, secondary, and latent syphilis. US CDC Recommendations: Primary, secondary, and early latent syphilis: 2.4 million units IM as a single dose. Retreatment of primary or secondary syphilis (without neurosyphilis): 2.4 million units IM once a week for 3 weeks.
When benzathine or procaine penicillin cannot be used (eg, owing to penicillin allergy where penicillin desensitization is not possible) or is not available (eg, owing to stock-outs), the...
Clinical experience indicates that an interval of 10–14 days between doses of benzathine penicillin for latent syphilis might be acceptable before restarting the sequence of injections (i.e., if dose 1 is administered on day 0, dose 2 is administered on days 10–14).
syphilis–physician’s pocket guide. Syphilis is a systemic, sexually transmitted disease (STD) caused by the Treponema pallidum bacterium. syphilis transmission. Three means of syphilis transmission: Person to person via vaginal, anal, or oral sex through direct contact with a syphilis chancre.
The management of syphilis is based upon its classification into stages of disease: early syphilis (includes primary, secondary, and early latent syphilis); late (includes late latent, cardiovascular, and gummatous syphilis); and neurosyphilis (includes central nervous system disease and ocular syphilis at any time).
Penicillin continues to be the treatment with the greatest benefits compared with other antibiotics used for syphilis during pregnancy, and while there is little data for azithromycin the available data indicate that this treatment has the greatest potential for harm.
Empiric treatment with one dose of benzathine penicillin G 2.4 million units intramuscularly (IM) is recommended in all patients who have had sexual contact with a partner who has tested...