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The treatment of syphilis is determined by the length of time the individual has been infected. Primary, secondary or latent syphilis of less than one year duration is treated as follows:
- Benzathine penicillin, 2.4 million units injected into a muscle (IM) as a single dose
- Doxycycline 100 mg (milligrams) by mouth twice per day for 15 days
- Tetracycline 500 mg by mouth four times per day for 15 days
- Erythromycin 500 mg by mouth four times per day for 2 weeks
- Ceftriaxone 250 mg IM daily for 10 days
For treatment of syphilis of greater than one year duration:
- Benzathine penicillin 2.4 million units IM weekly for 3 weeks
- Doxycycline 100 mg by mouth twice per day for 30 days
- Tetracycline 500 mg by mouth twice per day for 30 days
Neurosyphilis:
- Aqueous penicillin G 12 to 24 million units injected into a vein (IV) daily for 10 days followed by benzathine penicillin 2.4 million units IM once a week for 3 weeks
- Procaine penicillin 2.4 million units IM daily; given with oral probenecid 500 mg four times per day--both for 10 days. This is followed by benzathine penicillin 2.4 million units once a week for 3 weeks.
Syphilis during pregnancy: Text Continues Below
Penicillin is recommended as the only real drug of choice. Tetracycline can not be used because of toxicity to the fetus and erythromycin may fail to prevent congenital syphilis in the fetus. Penicillin-allergic individuals should be desensitized and then treated with penicillin.
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