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

EUR/03/5045931
page 41
Specific treatment of children diseased with early congenital symptomatic and latent syphilis
and, treatment in case if pathology in CSF is absent.
A. Treatment without pathology in liquor
Method 1
Benzylpenicillin (sodium) in a doze of 100 000 units per 1 kg of weight, divided into 6 injections
is taken every 4 hours daily, within 14 days.
Method 2
Novocaine salt of benzylpenicillin in a daily doze 50 000 units per 1 kg, divided into 2 injections
with an interval of 12 hours is taken twice a day; or procaine penicillin in the same dose is
injected daily within 14 days.
Method 3
Carried newborn if having no hypotrophy (weight not less than 2 kg) may be treated with foreign
long-lasting penicillin preparations (extencilline, retarpene); one doze is 50 000 units/kg of
weight, once a week. The course consists of 3 injections. Each dose is divided into 2 parts and
injected in both buttocks.
B. Treatment with liquor pathology or without liquor test
Treatment can be carried out with penicillin and novocaine salts or with procaine penicillin
according to the above-mentioned methods (section А, methods 1 and 2).
Lasting penicillin preparations application is not recommended.
In case of benzylpenicillin intolerance it is necessary to use semisynthetic penicillins –
oxacilline, ampicilline, in the same daily dosage as soluble penicillin which is divided into four
parts and injected intramuscularly four times a day. Duration of treatment is the same, as with
benzylpenicillin.
In case of all penicillin group intolerance ceftriaxone application is preferable. The daily dose is
of 80–50 mg/kg of weight, treatment duration is 14 days.
Treatment of a late congenital syphilis
Procaine penicillin in a daily dose at the rate of 50 000 units per 1 kg of weight is applied once a
day within 28 days; a repeating 14 days course should be done after a two-week interval.
Novocaine salt of penicillin in the same daily dose divided into two injections may also be used.
The therapy duration is the same as well.
Method 1
Water-soluble penicillin in a daily dose at the rate of 50 000 units per 1 kg of body weight
divided into 6 injections in a day can be applied. The first therapy course lasts 28 days, the
second one lasts 14 days and should be done after a two-week interval.