The recommended antibiotics for neurosyphilis is aqueous crystalline penicillin G 18-24 million units daily as 3-4 million units IV q4h or via continuous infusion for 10-14 d. If there's a reason to also be on ceftriaxone I would double cover to be safe.
See the CorePendium chapter on syphilis: https://www.emrap.org/corependium/chapter/reccYRR01VpOzQNWA/Syphilis#h.5ajrs6cflzfp
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Dennis C. - September 29, 2020 5:30 AM
Is 4 million units of IV Penicillin needed for presumptive neurosyphilis if I am already treating with high dose IV ceftriaxone empirically?
Jess Mason - September 29, 2020 12:52 PM
The recommended antibiotics for neurosyphilis is aqueous crystalline penicillin G 18-24 million units daily as 3-4 million units IV q4h or via continuous infusion for 10-14 d. If there's a reason to also be on ceftriaxone I would double cover to be safe.
See the CorePendium chapter on syphilis: https://www.emrap.org/corependium/chapter/reccYRR01VpOzQNWA/Syphilis#h.5ajrs6cflzfp