1. DISEASE RECOMMENDED Rx DOSE/ROUTE ALTERNATIVES
Syphilis(2010)
Primary,secondary,orearlylatent benzathine penicillinG 2.4 millionunitsIMina single dose doxycycline6,28100 mg 2x/dayfor 14 days OR
tetracycline6,28500 mg orally4x/dayfor14 days
Latent>1 year,latentof unknown
duration
benzathine penicillinG 2.4 millionunitsIMin3 doseseachat 1
weekintervals(7.2millionunitstotal)
doxycycline6,28100 mg 2x/dayfor 28 days OR
tetracycline6,28500 mg orally4x/dayfor28 days
Pregnancy3 See complete CDCguidelines
Neurosyphilis aqueouscrystallinepenicillinG 3 to 4 millionunitsIV every4hoursfor
10-14 days(18-24 millionunits/day)
procaine penicillinG2.4 MU IM 1x daily PLUS
probenecid500 mg orally4x/day,bothfor10-14 days.
Congenital syphilis aqueouscrystallinepenicillinG
OR
procaine penicillinG
-100,000-150,000 units/kg/day(50,000
units/kg/doseIV every12hours) during
the first7 daysof life andevery8 hours
thereafterforatotal of 10 days
- 50,000 units/kg/doseIMina single
dose for10 days
Children:primary,secondary,or
earlylatent
benzathine penicillinG 50,000 units/kgIMina single dose
(maximum2.4millionunits)
Children:latent>1year,latentof
unknowndurationb
benzathine penicillinG 50,000 units/kgIMfor3 dosesat 1
weekintervals(maximumtotal 7.2
millionunits)
Syphilis(2015)
Primary,secondary,orearlylatent benzathine penicillinG 2.4 millionunitsIMina single dose doxycycline3,25100 mg 2x/dayfor 14 days OR
tetracycline3,25500 mg orally4x/dayfor14 days
Latent>1 year,latentof unknown
duration
benzathine penicillinG 2.4 millionunitsIMin3 doseseachat 1
weekintervals(7.2millionunitstotal)
doxycycline3,25100 mg 2x/dayfor 28 days OR
tetracycline3,25500 mg orally4x/dayfor28 days
Pregnancy See complete CDCguidelines.
Neurosyphilis aqueouscrystallinepenicillinG 18–24 millionunitsperday,
administeredas3–4 millionunitsIV
every4 hoursor continuousinfusion,
for 10–14 days
procaine penicillinG2.4 MU IM 1x dailyPLUS
probenecid500 mg orally4x/day,bothfor10-14 days
Congenital syphilis See complete CDCguidelines. See CDC STD Treatmentguidelinesfordiscussionof
alternative therapyinpatientswithpenicillinallergy
Children:Primary,secondary,or
earlylatent
benzathine penicillinG 50,000 units/kgIMina single dose
(maximum2.4millionunits)
Children:Latent>1 year,latentof
unknownduration
benzathine penicillinG 50,000 units/kgIMfor3 dosesat 1
weekintervals(maximumtotal 7.2
millionunits)

2. DISEASE RECOMMENDED Rx DOSE/ROUTE ALTERNATIVES
Trichomoniasis(2010)
metronidazole OR
tinidazole
2 g orallyina single dose
2 g orallyina single dose
metronidazole 500 mg 2x/dayfor 7 days
Trichomoniasis(2015)
metronidazole OR
tinidazole
2 g orallyina single dose
2 g orallyina single dose
metronidazole22500 mg 2x/dayfor7 days
Persistentorrecurrent
trichomoniasis
metronidazole
If this regimenfails:
metronidazole OR
tinidazole
If this regimenfails,
susceptibilitytestingis
recommended.
500mg orally2x/dayfor 7 days
2g orallyfor7 days
2g orallyfor7 days