SYPHILIS – ANTIBIOTIC TREATMENT 3
Antenatal screening and control of early infectious syphilis are essential for the control of congenital syphilis. Seropositive women must be evaluated and treated promptly. Regardless of the stage of pregnancy, patients who are not allergic to penicillin should be treated with penicillin according the regimens above. Pregnant patients with confirmed penicillin sensitivity should be referred for specialist care. If erythromycin is used, patient and infant must be closely followed for possible treatment failure.
Congenital syphilis
Benzylpenicillin 30 to 60 mg mg/kg (for neonates) daily intramuscularly or intravenously in 2 divided doses for a minimum of 10 days; or Aqueous procaine penicillin G 50 mg/kg daily intramuscularly for a minimum of 10 days or Benzathine penicillin G 50,000 units/kg in a single dose ONLY IF CSF IS NORMAL. If there is CNS involvement, extended treatment with benzylpenicillin is recommended.
Only penicillin regimens are recommended for neonatal congenital syphilis. Tetracycline should not be used for children under the age of 8 years. Infants with congenital syphilis should be referred for specialist advice.
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