SYPHILIS – PENICILLIN SENSITIVE PATIENTS

For any patient with syphilis who can not be treated with penicillin, specialist advice should be sought. A tetracycline such as doxycycline is the second line drag of choice. Erythromycin is less reliable and is rarely indicated. Recommended regimens for these drugs are:

Early syphilis

Doxycycline 300 mg daily orally in single or divided doses for 15 days; OR

Erythromycin (not estolate) 500 mg 4 times daily orally for 15 days. Late latent syphilis

Doxycycline 300 mg daily orally in single or divided doses for 30 days OR

Erythromycin (not estolate) 500 mg 4 times daily orally for 30 days.

For patients with neurosyphilis, penicillin allergy should be confirmed as the effectiveness of treatment with other drags is uncertain.

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