Updated Recommendation
A new evidence synthesis was published:2024, Updated recommendations for the treatment of Neisseria gonorrhoeae, Chlamydia trachomatis, and Treponema pallidum (syphilis) and new recommendations on syphilis testing and partner services.
View latest version (2024)Bibliographic Info
Recommendation
Recommended in favor
Conditional
Certainty of evidence
Very low
In pregnant women with early syphilis, the WHO STI guideline suggests using benzathine penicillin G 2.4 million units once intramuscularly over procaine penicillin 1.2 million units intramuscularly once daily for 10 days. When benzathine or procaine penicillin cannot be used (e.g. due to penicillin allergy where penicillin desensitization is not possible) or are not available (e.g. due to stockouts), the WHO STI guideline suggests using, with caution, erythromycin 500 mg orally four times daily for 14 days or ceftriaxone 1 g intramuscularly once daily for 10–14 days or azithromycin 2 g once orally
Notes and Remarks
- 1.This is defined as: positive syphilis test with history of primary syphilis manifested as genital ulcer (painless chancre) at the site of infection; or secondary syphilis manifested by skin rash often seen on the palms of the hands and soles, condylomata lata, mucocutaneous lesions and generalized lymphadenopathy; or early latent syphilis manifested by no symptoms and known duration of untreated infection of not more than two years.
Also Featured In
This recommendation also appears in the following guidelines:
WHO guideline on syphilis screening and treatment for pregnant women