Latent syphilis
ICD-10 A53.0 · ICD-11 1A63

Treatment of Early Latent Syphilis Acquired Within 1 Year — No Penicillin Allergy

This protocol covers first-line management of early latent syphilis in a patient with no penicillin allergy and no bleeding disorder — the standard uncomplicated presentation.

Clinical Scenario

Early latent syphilis refers to infection acquired within the first year. This threshold is used to distinguish early from late (or undetermined-duration) latent infection. The absence of penicillin allergy and bleeding disorder places this patient squarely in the standard first-line pathway.

Early latent syphilis Acquired <1 year No penicillin allergy No bleeding disorder

First-Line Treatment

The first-line regimen involves benzathine penicillin G (BPG). The complete dosing schedule, administration details, and the full protocol algorithm are available below.

Dose, route, and schedule details are in the structured protocol — access it via the button below.

Treatment Goal

After treatment, the titre of a non-treponemal test (VDRL or RPR) drawn at day 0 is monitored. The expected serological response is a decline of ≥2 dilution steps (a ≥fourfold decrease in antibody titre) within 6 months.

Instant Access to Structured Evidence-Based Regimens

References

DOI: 10.1111/jdv.16946

Rather arbitrarily classified as early if within the first year of infection and late (or undetermined duration) after ≥1 year.

Early syphilis (Primary, Secondary and Early latent, i.e. acquired <1 year previously)

BPG 2.4 million units intramuscularly (IM), given as one injection of 2.4 million units or two separate injections of 1.2 million units in each buttock, on day 1

After treatment of early syphilis, the titre of a NTT taken at day 0 (e.g. VDRL and/or RPR) should decline by ≥2 dilution steps (≥fourfold decrease in titre of antibodies) within 6 months.

View source ↗