Chronic Suppression

1. Acyclovir (Zovirax) 400 mg PO bid [C]

2. Famciclovir (Famvir) 250 mg PO bid [B]

3. Valacyclovir (Valtrex) 500 PO qd OR 250 mg PO bid [B]



1. Consider HIV testing.

2. Treatment failures may occur with any regimen. Patients should be reexamined in 3 and 6 months.

3. Three weekly injections of benzathine penicillin are recommended for treatment failures, latent infections >1 year, and for HIV-infected patients.

1. Benzathine penicillin G (Bicillin L-A) strongly preferred, use alternatives only if penicillin allergy (consider desensitization in patients with a penicillin allergy) [B]

a. a. Children: 50,000 units/kg IM single dose (max 2.4 million units)

b. b. Adults: 2.4 million units IM single dose

If penicillin allergic:

1. Doxycycline (Vibramycin) 100 mg PO bid for 14 days [D] OR

2. Tetracycline 500 mg PO qid for 14 days [D]

Organism: Treponema pallidum

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