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

EUR/03/5045931
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of ceftriaxone therapy is limited nowadays. The following recommendations on its usage have
been compiled on a base of few abroad and our own results data.
Ceftriaxon is prescribed in a following way:
Preventive treatment – 0.25 g intramuscular daily, totally 5 injections
Primary syphilis – 0.5 g intramuscular daily, totally 10 injections
For the patients having late latent and neurosyphilis daily dose of the preparation 1.0–2.0 g with
one injection is recommended. The therapy lasts 14 days. In severe cases (syphilitic
meningoencephalitis, acute generalised meningitis) intravenous usage and increasing of a daily
dose up to 4.0 are possible.
Azytromycine is recommended only in case of all other reserve antibiotics intolerance. It should
be taken in the conditions of strict clinical and serological control. A daily dose of the
preparation for an early syphilis form treatment is 0.5 (per one intake), the treatment duration is
10 days.
10. Specific and preventive treatment of pregnant women
Due to effective and short-term modern techniques of diagnosis and of treatment, syphilis is not
a reason for pregnancy interruption nowadays. The decision to keep on or to interrupt pregnancy
is taken by woman herself.
A. Specific treatment of pregnant women up to 18 weeks inclusive
Treatment of pregnancy up to the 18th week inclusive is carried out in the same way as common
treatment according to the diagnosis, following one of the methods suggested in the present
recommendations.
B. Specific treatment of pregnant women at term more than 18weeks
Treatment of the pregnant women with primary syphilis
Method 1
Procaine penicillin in a single doze 1.2 million units daily no. 10 or novocaine salt of penicillin
600 000 units twice a day are to be taken for 10 days.
Method 2
Treatment with sodium salt of penicillin 1 million units intramuscular 4 times a day for 10 days
is prescribed.
Treatment of the pregnant women having secondary and early latent syphilis
Method 1
Treatment is carried out with procaine penicillin, 1.2 million units per an injection daily, within
20 days; or with novocaine salt of penicillin, 600 000 units twice a day, for 20 days.
Method 2
Treatment with soluble penicillin (sodium ), 1 million units 4 times a day for 20 days.
Preventative treatment of pregnant women
Preventive treatment is prescribed for the women who received treatment before the pregnancy
and didn’t achieve complete serology (Wassermann) negativation, as well as for women having