Syphilis / Primary & Secondary

Benzathine penicillin G 2.4 million units IM in a single dose  

* Recommendations for treating syphilis among persons with HIV infection and pregnant women are discussed elsewhere in this report (see Syphilis Among Persons with HIV Infection; Syphilis During Pregnancy). 

Benzathine penicillin G 2.4 million units IM in a single dose  

Benzathine penicillin G 50,000 units/kg body weight IM, up to the adult dose of 2.4 million units in a single dose 

Pregnant women should be treated with the recommended penicillin regimen for their stage of infection.

Certain evidence indicates that additional therapy is beneficial for pregnant women to prevent congenital syphilis. For women who have primary, secondary, or early latent syphilis, a second dose of benzathine penicillin G 2.4 million units IM can be administered 1 week after the initial dose.

Parenteral penicillin G is the only therapy with documented efficacy for syphilis during pregnancy. Pregnant women who are allergic to penicillin should be desensitized and treated with penicillin G. Skin testing or oral graded penicillin dose challenge might be helpful in identifying women at risk for acute allergic reactions.