Pediatric Guidelines: Sexually Transmitted Infections (Adolescent) - Syphilis

Condition Major Pathogens First Choice Therapy Alternative Therapy Comments
Syphilis Treponema pallidum

Primary, secondary, or early latent: 

Benzathine Penicillin G 50,000 units/kg up max to 2.4 million units IM x 1

Penicillin allergy:

Contact ID/ASP

Sexual partners should be treated

Late latent, or latent of unknown duration:

Benzathine Penicillin G 50,000 units/kg/dose up to max 2.4 million units/dose IM qweek x 3 doses

Reference: Workowski KA, Bolan GA, Centers for Disease Control and Prevention. Sexually transmitted diseases treatment guidelines, 2015. Morbid Mortal Wkly Recomm Rep 2015;64:1-138. 

These are guidelines only and not intended to replace clinical judgment. Modification of therapy may be indicated based on patient comorbidities, previous antibiotic therapy or infection history. Doses provided are usual doses but may require modification based on patient age or comorbid conditions. Refer to Pediatric Antimicrobial Dosing Guideline for further guidance on dosing in children, and Neonatal Dosing Guideline for infants < 1 month of age. Consult a pediatric pharmacist for individualized renal or hepatic dose adjustment. For additional guidance, please contact Pediatric Infectious Diseases (ID) or the Pediatric Antimicrobial Stewardship Program (ASP).