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Treatment of choice is administration of penicillin I.M. or I.V. depending on the infection’s stage. After therapy, follow-up RPR tests are usually done to check for adequacy of treatment. The nonpregnant patient who is allergic to penicillin may be treated with tetracycline or doxycycline. Nonpenicillin therapy for latent or late syphilis should be used only after neurosyphilis has been excluded. Tetracycline is contraindicated in the pregnant woman because it causes discoloration of the infant’s teeth. If a pregnant woman with syphilis is allergic to penicillin, desensitization is recommended to permit the use of penicillin.
Source: Professional Guide to Diseases (Eighth Edition), 2005
Administration of penicillin I.M. is the treatment of choice. For early syphilis, treatment may consist of a single injection of penicillin G benzathine I.M. (2.4 million units). Syphilis of more than 1 year’s duration should be treated with penicillin G benzathine I.M. (2.4 million units/week for 3 weeks).
Nonpregnant patients who are allergic to penicillin may be treated with oral tetracycline or doxycycline for 15 days for early syphilis and for 30 days for late infections. Nonpenicillin therapy for latent or late syphilis should be used only after neurosyphilis has been excluded. Tetracycline is contraindicated in pregnant women. Patients who receive treatment must abstain from sexual contact until the syphilis sores are completely healed.
CLINICAL TIP: Rashes from secondary syphilis will clear up without treatment.
Source: Handbook of Diseases, 2003
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