Review of Current Evidence and Comparison of Guidelines for ...

Table 6
Congenital
EUR/03/5045931
page 25
European Treatment Benzyl Penicillin PBP BBP if CSF normal
Penicillin
allergy
No guidelines
United
Kingdom
Dose 150 000 units/kg 50 000
units/kg
Regime Over 6
doses/day
50 000 units/kg
od od
Route IV IM IM
Duration 10–14 days 10–14 days 1 day
Treatment Benzyl penicillin PBP No guidelines
Dose 50 000 units/kg 50 000 units/kg
Regime bd then tds od
Route IV IV IM
Duration 7 days 3 days 10 days
United States Treatment Benzyl Penicillin PBP BBP* Penicillin
Desensitization
Russian
Federation
Dose 50 000 units/kg 50 000 units/kg 50 000 units/kg
Regime bd then tds od ow
Route IV IV IM IM
Duration 7 days 3 days 10 days 1 day
Early Congenital Syphilis
Penicillin
allergy
Treatment Benzyl penicllin NBP PBP BBP Ceftriaxone or
Oxacillin or
Ampicillin
Dose 100 000 u/kg 50 000 u/kg 50 000 u/kg 50 000 u/kg 100 000 u/kg
Regime Over 6
doses/day
Over 2
doses/day
od Ow Over 4
doses/day
Route IV IM IM IM IM
Duration 14 days 14 days 14 days 3 weeks 14 days
Only if CSF normal & not >2 kg
Late congenital syphilis
Treatment Benzyl Penicillin NBP PBP
Penicillin
allergy
No guidelines
Dose 50 000 u/kg 50 000 u/kg 50 000 u/kg
Regime Over 6
doses/day
Over 2
doses/day
Route IV IM IM
Duration 28 days, 14
days off, 14
days
28 days, 14
days off, 14
days
od
28 days, 14 days off, 14 days
* Normal examination + titres, mother untreated; non penicillin regime see text of guidelines for more details