O98.1
DIAGNOSTIC CRITERIA
Most pregnant women are asymptomatic.
See PHC STGs and EML Syphilis serology and treatment
GENERAL MEASURES
Inform contact(s).
MEDICINE TREATMENT
Mother (treat as either early or late latent/unknown or early stage of syphilis):
For late latent syphilis or syphilis of unknown duration
- Benzathine benzylpenicillin (depot formulation), IM, 2.4 million units diluted in 6 mL 1% lidocaine without adrenaline (epinephrine), weekly for 3 doses .
Note: If the mother has received <3 doses, treat the baby for congenital syphilis.
For early syphilis
- Benzathine benzylpenicillin (depot formulation), IM, 2.4 million units diluted in 6 mL 1% lidocaine without adrenaline (epinephrine), immediately as a single dose.
Severe penicillin allergy (Z88.0)
For penicillin sensitive pregnant women: penicillin desensitisation.
(See for detailed information ).
Oral penicillin desensitisation regimen.
|
A: Reconstitute phenoxymethylpenicillin 250mg/ 5mL |
||
| Step | Medicine mg/mL |
Amount to administer (mL) |
| Strictly every 15 minutes |
B: To make 0.5mg/mL solution Dilute 0.5 mL of reconstituted phenoxymethylpenicillin solution in 49.5 mL water. |
|
| 1 |
0.5 mg/mL solution (1000 units/mL) |
0.1 mL |
| 2 |
0.5 mg/mL solution (1000 units/mL) |
0.2 mL |
| 3 |
0.5 mg/mL solution (1000 units/mL) |
0.4 mL |
| 4 |
0.5 mg/mL solution (1000 units/mL) |
0.8 mL |
| 5 |
0.5 mg/mL solution (1000 units/mL) |
1.6 mL |
| 6 |
0.5 mg/mL solution (1000 units/mL) |
3.2 mL |
| 7 |
0.5 mg/mL solution (1000 units/mL) |
6.4 mL |
|
C: To make 05 mg/mL solution Dilute 1 mL of reconstituted phenoxymethylpenicillin solution in 9 mL water. |
||
| 8 |
5 mg/mL solution (10000 units/mL) |
1.2 mL |
| 9 |
5 mg/mL solution (10000 units/mL) |
2.4 mL |
| 10 |
5 mg/mL solution (10000 units/mL) |
4.8 mL |
|
D: Reconstituted phenoxymethylpenicillin 250mg/ 5mL = 50 mg/mL |
||
| 11 |
50 mg/mL (80000 units/mL) |
1.0 mL |
| 12 |
50 mg/mL (80000 units/mL) |
2.0 mL |
| 13 |
50 mg/mL (80000 units/mL) |
4.0 mL |
| 14 |
50 mg/mL (80000 units/mL) |
8.0 mL |
After step 14, observe for 30 minutes, then 1.0 g IV; Interval between doses: 15 minutes.
Asymptomatic, well baby:
Mother has syphilis and has not been treated, or was only partially treated:
- Benzathine benzylpenicillin (depot formulation), IM, 50 000 units/kg as a single dose into the antero-lateral thigh.
Symptomatic baby
- Procaine penicillin, IM, 50 000 units/kg daily for 10 days. (Not for I.V. use).
OR
- Benzylpenicillin (Penicillin G), IV, 50 000 units/kg, 12 hourly for 10 days.