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Dr. SH
Dr. SH, Board Certified Physician
Category: Medical
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Experience:  Doctor of Medicine
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For the someone with symptoms of secondary syphilis. Can you

Resolved Question:

For the someone with symptoms of secondary syphilis. Can you recommend the correct course of antibiotics if penicillin allergy is suspected.
Submitted: 2 years ago.
Category: Medical
Expert:  Dr. SH replied 2 years ago.

Dr. Shahzad MD :

Hi there. Thank you for your question. I will be helping you out with your queries

Dr. Shahzad MD :

According to the Centers for Disease Control and Prevention (CDC), patients with known penicillin allergies should undergo penicillin allergy skin testing and penicillin desensitization, if necessary.

Dr. Shahzad MD :

The 2010 CDC STD treatment guidelines recommend desensitization in penicillin-allergic pregnant women, followed by treatment with penicillin.

Dr. Shahzad MD :

Doxycycline is used as alternative therapy for syphilis infection.

Dr. Shahzad MD :

Initial therapy: 200 mg/day divided twice daily for the first 24 hours which may either be given orally or intravenously. THEN


Maintenance: 100-200 mg/day

Dr. Shahzad MD :

Let me know if you have any further questions.

Dr. Shahzad MD :

Rate me for my services when you are done.

Dr. Shahzad MD :

Kindest Regards

Dr. SH, Board Certified Physician
Category: Medical
Satisfied Customers: 8765
Experience: Doctor of Medicine
Dr. SH and 4 other Medical Specialists are ready to help you
Customer: replied 2 years ago.

Unsure about the dosage on first day - is it 200mg in one go or divided into parts? Then you say between 100-200mg maintenance, but for how many days should this continue? 40Yr Male in good general health.

Expert:  Dr. SH replied 2 years ago.

100 mg 12 hourly in the first 24 hours i.e. two doses of 100 mg twelve hours apart. Then you should take 100 mg once daily or 100 mg twice daily depending on the severity of infection for 28 days.

Customer: replied 2 years ago.


Would you recommend the single 2g dose of azithromycin?

Expert:  Dr. SH replied 2 years ago.
That is recommended for chlamydial infection. Its not proven for syphilis.
Customer: replied 2 years ago.

Can Doxycycline be taken simply as 2 x 100mg for 14 days with the same outcome? What are the dangers of leaving secondary syphilis untreated for a few weeks once classic signs (rash on palms of hands and feet) begin to appear?

Expert:  Dr. SH replied 2 years ago.
It must be treated.
Dangers are that it can turn into tertiary syphilis with grave consequences.
Treatment of choice, I want to mention again, is penicillin.
Customer: replied 2 years ago.

Being in a foreign country with a few weeks remaining before returning back to Europe (and then be treated) was the background to my question as to 'what are the consequences of leaving (suspected) secondary syphilis untreated for a few weeks'? My understanding is that tertiary syphilis develops some time after secondary?

Expert:  Dr. SH replied 2 years ago.
Yes it does take some time for tertiary syphilis to develop.
But at least you should be tested and be seen to make sure its syphilis and nothing else.

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