A 30-year-old woman is diagnosed with secondary syphilis. She is allergic to penicillin. What is the recommended alternative treatment?

• A Doxycycline 100 mg BD for 14 days ✓
• B Azithromycin 2 g single dose
• C Ceftriaxone 1 g IM daily for 10 days
• D Erythromycin 500 mg QID for 14 days

Explanation

For non-pregnant penicillin-allergic patients with early syphilis (primary, secondary, or early latent), doxycycline 100 mg twice daily for 14 days is the recommended alternative per WHO and national guidelines. Azithromycin resistance among T. pallidum strains (A2058G mutation) is now widespread and it is no longer reliably recommended. Desensitization to penicillin is recommended for pregnant women who are allergic. Tetracyclines are contraindicated in pregnancy.

Reference: Neena Khanna Illustrated Synopsis of Dermatology & STD, 6th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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