SYPHILIS – ANTIBIOTIC TREATMENT

Parenteral penicillin is the drug of choice. Alternative antibiotics should only be used where there is a history of penicillin sensitivity.

Early syphilis

Aqueous procaine penicillin G 1.5 g daily intramuscularly for a minimum of 10 days;

Benzathine penicillin G 1.8 g intramuscularly in a single dose for patients unable to comply with daily injections, preferably repeated 7 days later.

Late latent syphilis

Aqueous procaine penicillin G 1.5 g daily intramuscularly for 15 days; OR

Benzathine penicillin 1.8 g intramuscularly at 7 day intervals for 3 doses for patients unable to comply with daily injections.

Benign gummatous syphilis

Aqueous procaine penicillin G 1.5 g daily intramuscularly for 21 days; OR

Benzathine penicillin G 1.8 g intramuscularly at 7 day intervals for 3 doses for patients unable to comply with daily injections. This should never be used in late syphilis unless the CSF is negative.
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