GENITOURINARY - STI, Syphilis - Primary, Secondary, and Early Latent (Treponema pallidum) General statement: Penicillin G is the preferred drug for treatment of syphilis. Pregnant patients and patients with neurosyphilis with a history of allergy to penicillin should be desensitized and treated with penicillin if possible.
Penicillin G benzathine (Bicillin L-A^®, Permapen^®) Pregnancy: B; Lactation: Unk Injection (IM only): 300,000 U/mL and 600,000 U/mL (1 mL, 2 mL, 4 mL)		Children: 50,000 U/kg up to adult dose IM ´1 dose. Adolescents and Adult: 2.4 mU ´1 IM divided in two sites.	Important side effects: Jarisch- Herxheimer reaction, pain at injection site. Caution: Do not give IV, IA, or SC. Use with caution in persons with history of seizures.
Doxycycline (Vibramycin^®) Generics available Pregnancy: D; Lactation: Unsafe Caps: 50 mg, 100 mg – Tabs: 100 mg *For use only in nonpregnant patients with documented penicillin allergy, likely good compliance and follow-up.		Adolescents and Adults: 100 mg twice daily for 14 days.	Food: May take with food if GI upset occurs. Take 1 hour before or 2 hours after antacids, iron, milk, or other dairy products. Take with full glass of water to prevent esophagitis. Important side effects: Photosensitivity, use sunscreen. Esophagitis. May discolor fingernails.
Tetracycline (Sumycin^®, Achromycin V^®) Generics available Pregnancy: D; Lactation: Unsafe Caps: 250 mg, 500 mg Tabs: 250 mg, 500 mg   *For use only in nonpregnant patients with documented penicillin allergy, likely good compliance and follow-up.		Adult: 500 mg four times daily for 14 days.	Food: Take 1 hour before or 2 hours after meals. Do not take with dairy products, antacids, calcium, zinc, or iron products. Take with large glass of water to prevent esophagitis. Important side effects: GI upset, esophagitis, photosensitivity, discoloration of fingernails, superinfection (vaginal candidiasis). Use with caution in liver or renal disease.
GENITOURINARY - STI, Syphilis - Pregnancy (Treponema pallidum)
Penicillin G benzathine (Bicillin L-A^®, Permapen^®) Pregnancy: B; Lactation: Unk Injection (IM only): 300,000 U/mL and 600,000 U/mL (1 mL, 2 mL, 4 mL)	Adolescent and Adults: 2.4 mU IM ´ 1, divided in two sites.		Important side effects: Jarisch-Herxheimer reaction, pain at injection site. Caution: Do not give IV, IA, or SC. Use with caution in persons with history of seizures.