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

EUR/03/5045931
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started the treatment while their pregnancy, irrespective of its term. Preventive treatment usually
starts after the twentieth week of pregnancy, though if specific treatment was started late, then
preventive treatment is carried out directly after specific treatment.
Method 1
Procaine penicillin, 1.2 million units is taken daily, within 10 days; or novocaine salt of
penicillin, 600 000 units is taken twice a day, within 10 days.
Method 2
Treatment with sodium salt of benzylpenicillin, 1 million units 4 times day, within 10 days is
carried out.
In case of penicillin intolerance semisynthetic penicillins or erythromycine (see “Alternative
(reserve) methods of treatment of a syphilis”) are prescribed for injection while pregnancy.
11. Children’s syphilis treatment and prevention
Preventive treatment of children
In cases if a child delivered to mother who has not been treated from syphilis, or the treatment
started late (after the thirty-second week of pregnancy), or absence of serology conversion by the
moment of delivery, or mother’s serofast, then the child should go through preventive treatment
course.
Preventive treatment of the child delivered to an untreated syphilis infected mother is carried out
according to any method recommended for inborn syphilis treatment.
Preventive treatment connected with insufficient treatment of mother, positive serologic
reactions (RPR, VDRL) by the moment of delivery, or mother’s serofast carried out according to
one of the following methods:
Method 1
Benzylpenicillin (soduim), 100 000 units per 1 kg of weight is given to the child for 10 days.
Daily doze is shared into 6 injections.
Method 2
Penicillin novocaine salt, 50 000 units per 1 kg of weight, divided into 2 injections is injected
twice a day with 12 hours interval; or procaine penicillin at the same daily dose is injected one
time a day.
Method 3
Treatment with foreign long-lasting preparations of benzathinpenicillin – extencillin or retarpen,
in a single dose at the rate of 50 000 units per 1 kg of weight, once a week, totally 2 injections.
In case of penicillin intolerance by the child it is possible to accomplish the treatment by
semisynthetic penicillin, keeping duration of treatment same as in case of preventive treatment
by soluble penicillin.
The technique of preventive treatment by ceftriaxone hasn’t been yet worked out completely. It
is known from the literary data, that the treatment is carried out for 10 days, in a daily dose of 50
mg/kg, entered in one injection.