4- Pregnant females:
A) Primary , secondary and early latent syphilis(less than one year):
The CDC recommends “benzathine penicillin G” single dose
In the case of penicillin allergy, CDC recommends “erythromycin” 4 times daily orally (500 mg) for 14 days or ceftriaxone once daily intramuscular (1g ) for 10-14 days or azithromycin once orally (2g).
Doxycycline is contraindicated in pregnant females, as it crosses the placenta, and thereafter the drug is delivered to the fetus as well.
Erythromycin doesn’t cross the placenta, thus it’s considered a preferred choice in case of penicillin allergy.
B) Late latent syphilis (more than one year) and syphilis of unknown duration:
The CDC recommends “benzathine penicillin G” 3 doses intramuscularly (2.4 million units per each dose) every one week.
In case of penicillin allergy, CDC recommends “erythromycin” 4 times daily orally (500 mg) for 30 days .
Surgical treatment may be required in late stages.
