Page 148 - HPP ANTIMICROBIAL GUIDELINE 2018
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SEXUALLY TRANSMITTED INFECTIONS
Suggested Treatment
Infection/ Condition Comments
Preferred Alternative
Syphilis
Primary Benzathine penicillin G 2.4MU IM Penicillin Allergy Contact tracing:
Secondary STAT Doxycycline 100mg PO q12h for Examine and investigate sex partner
Early latent 14 days and treat when indicated
1.
Late latent syphilis Benzathine penicillin G 2.4MU IM Penicillin Allergy
Gummatous syphilis weekly for 3 weeks Doxycycline 100mg PO q12h for
Cardiovascular syphilis 28 days
Neurosyphilis IV Benzylpenicillin 18-24 MU/day, Penicillin allergy: All patients with neurosyphilis should
Ocular syphilis administered 3 - 4 MU q4h IV for 14 Ceftriaxone 2gm IM be considered for corticosteroid
days (with Lidocaine as diluent) or cover at the start of the therapy to
IV (with water for injection as prevent the Jarisch-Herxheimer
diluent) for 10-14 days reaction
(if no anaphylaxis to penicillin) (Prednisolone 10-20mg PO q8h for 3
days commencing one day prior to
syphilis treatment)
Syphilis in pregnancy Benzathine penicillin G 2.4 MU IM Only penicillin is currently Pregnant ladies with syphilis and
Primary, secondary and early latent recommended. history of penicillin allergy to be
desensitized only in tertiary centre
Tetracycline and doxycycline are
contraindicated in pregnancy
HPP AMG Sexually Transmitted Infections 69
