The reported incidence of primary and secondary syphilis rose more than 5% in the United States during the past year.
Some 21,676 cases were reported, and the actual total may be at least three times that figure. The Center for Disease Control (CDC), Atlanta, where these data are compiled, recommends penicillin G benzathine for "early" syphilis (primary, secondary, or latent infections of less than one year's duration).
Paul J. Wiesner, MD, director of the CDC's Venereal Disease Control Division, says penicillin G benzathine is the drug of choice because it usually provides effective treatment in a single injection (2.4 million units intramuscularly). An alternative is aqueous penicillin G procaine, 600,000 units daily, injected intramuscularly to a total of 4.8 million units in eight days.
For patients who are allergic to penicillin, CDC officials recommend oral drug regimens: tetracycline hydrochloride one hour before or two hours after meals for 15 days