New WHO guidelines for syphilis

The World Health Organization (WHO) has published updated treatment guidelines for syphilis “WHO guidelines for the treatment of Treponema pallidum (syphilis)” in view of the increasing and changing antimicrobial resistance patterns of syphilis and other sexually transmitted infections. Some key recommendations include:

• In adults and adolescents with early syphilis, benzathine penicillin G 2.4 million units once intramuscularly (IM) is recommended over procaine penicillin G 1.2 million units IM x 10–14 days.
• In cases of penicillin allergy or non availability, doxycycline 100 mg twice-daily orally x 14 days or ceftriaxone 1 g IM once-daily x 10–14 days is recommended. Avoid doxycycline in pregnant women.
• In pregnant women with early syphilis, benzathine penicillin G 2.4 million units once IM is recommended over procaine penicillin 1.2 million units IM once-daily x 10 days.
• Benzathine penicillin G 2.4 million units IM once weekly for three consecutive weeks is recommended over procaine penicillin 1.2 million units once-daily x 20 days in adults and adolescents with late syphilis or unknown stage of syphilis.
• In pregnant women with late syphilis or unknown stage of syphilis, benzathine penicillin G 2.4 million units IM once weekly for three consecutive weeks over procaine penicillin 1.2 million units IM once-daily x 20 days is advised.