Treatment of Late Latent Syphilis Acquired ≥1 Year Previously or of Unknown Duration — No Penicillin Allergy
This protocol addresses patients with late latent syphilis — syphilitic infection present for at least one year, or whose timing of acquisition cannot be established — who have no penicillin allergy.
Latent syphilis is classified as early if the infection occurred within the first year, and late (or undetermined duration) if ≥1 year has passed or the duration is unknown. This protocol specifically covers the late latent stage, which includes cardiovascular and gummatous presentations.
First-line management involves an intramuscular course of Benzathine penicillin G delivered across multiple treatment sessions — the complete schedule, dosing details, and administration instructions are set out in the full protocol.
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.
Late latent (i.e. acquired ≥1 year previously or of unknown duration), cardiovascular and gummatous syphilis.
BPG 2.4 million units 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, 8 and 15.