Spectrum: Local Antimicrobial Stewardship, for Eastern Health

Neurosyphilis

Consult

Infectious Diseases Team

Follow-up

Monitor RPR until seronegative or stable low titre (e.g. < 1:4 dilutions)

Monitoring Frequency

At 6, 12, and 24 months
(Monitor CSF every 6 months if CSF abnormalities present initially)

HIV infected patients (any stage):
At 1, 3, 6, 12, and 24 months, then yearly thereafter

First Line

Penicillin 3-4 million units IV q4h x 14 days

PEN G FOR IV INFUSION IS NOT THE SAME AS THE LONG ACTING BENZATHINE IM FORMUALTION USED FOR SYPHILIS; DOUBLE CHECK WHEN ORDERING OR DISPENSING