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Author: Admin | 2025-04-28
Is the drug of choice for the treatment of all stages of syphilis. Although efficacy is not well documented, the CDC states that use of oral doxycycline or oral tetracycline or, possibly, oral azithromycin, can be considered in nonpregnant adults and adolescents with primary, secondary, or early latent syphilis who are hypersensitive to penicillin. However, if compliance and follow-up cannot be ensured, these patients should be desensitized and treated with penicillin G. Use of penicillin alternatives (e.g., doxycycline, ceftriaxone, azithromycin) for the treatment of syphilis in HIV-infected individuals has not been studied and should be undertaken with caution.Erythromycin is no longer recommended by the CDC, AAP, or other clinicians for the treatment of syphilis in pregnant women who are hypersensitive to penicillin since numerous treatment failures (including in the fetus) have been reported with the drug. There are no proven alternatives to penicillin G for the treatment of syphilis during pregnancy, and pregnant women with a history of penicillin hypersensitivity should be desensitized, if indicated, and treated with penicillin G. Because erythromycin administered during pregnancy cannot be considered a reliable cure for the fetus, neonates born to a woman who received such treatment during pregnancy should be treated with penicillin G for presumed congenital syphilis.Erythromycin is not included in CDC recommendations for the treatment of presumed or documented congenital syphilis in neonates or for congenital syphilis in older infants and children. The CDC and AAP state that data are insufficient regarding efficacy of nonpenicillin regimens (e.g., ceftriaxone) for the treatment of syphilis in pediatric patients. Therefore, if treatment for syphilis is necessary in a neonate or child who has a history of penicillin hypersensitivity or who has developed an allergic reaction presumed to be related to penicillin, they should be desensitized and treated with penicillin G. Preoperative Intestinal AntisepsisOral erythromycin base is used in conjunction with oral neomycin sulfate as an adjunct to mechanical cleansing of the large intestine for intestinal antisepsis prior to elective colorectal surgery. For perioperative prophylaxis in patients undergoing colorectal surgery, many clinicians recommend a regimen of IV cefotetan or IV cefoxitin; a regimen of IV
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