Answer 4 Initiate IV penicillin G 2 to 4 million units every 4 hours for 14 days. Recommended treatment for neurosyphilis is aqueous crystalline penicillin G, 2 to 4 million units intravenously every 4 hours for 10 to 14 days. Although successful treatment of neurosyphilis with a 14-day regimen of IV ceftriaxone has been reported, use of ceftriaxone remains to be validated in large clinical trials. Levofloxacin is not recommended for treatment of any stage of syphilis. Oral doxycycline would be ineffective in the treatment of neurosyphilis. Click here to return to the questions
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