Treatment of congenital syphilis

1
Treatment of congenital syphilis

• World Health Organization
• Guidelines for the Management of Sexually
  Transmitted Infections
• April 2001

2
All children born to mothers who were
sero-positive during pregnancy

• A single intramuscular dose of benzathine
  benzylpenicillin 50,000 IU/kg

3
Treatment for early congenital syphilis

• Symptomatic infants
• Asymptomatic infants with abnormal cerebrospinal
  fluid

4
Alternative treatment regimes, early congenital
syphilis

• Aqueous benzyl penicillin 100 000-150,000 IU/kg
  intravenously, 50,000 IU/kg/dose every 12 hours
  the first 7 days, every 8 hours thereafter for a
  total of 10 days
• Procaine benzyl penicillin 50,000 IU/kg
  intramuscularly as a single daily dose for 10 days

5
Note

• Some experts treat all infants with congenital
  syphilis as if the cerebrospinal fluid findings
  were abnormal
• Antibiotics other than penicillin are not
  indicated for congenital syphilis except in cases
  of severe allergy to penicillin

6
Congenital syphilis of more than 2 years
duration

• Aqeous benzylpenicillin 200-000-300 000 IU/kg/day
  by intravenous or intramuscular injection,
  administered as 50,000 IU/kg every 4-6 hours for
  10-14 days.

7
Alternative regimen for penicillin-allergic
patients, after the first month of life

• Erythromycin 7,5-12,5/kg orally, 4 times daily
  for 30 days