Indication | Agent | Duration |
Initial therapy | ||
Initial phase* | ||
General infection | Ceftriaxone 2 g IV once daily OR Penicillin G 2 million units IV every four hours | Two weeks |
Endocarditis | Penicillin G 2 million units IV every four hours OR Ceftriaxone 2 g IV once daily | Four weeks |
Central nervous system disease¶ | Ceftriaxone 2 g IV once daily OR Penicillin G 4 million units IV every four hours | Two to four weeks |
If ceftriaxone and penicillin allergic | Meropenem 1 g IV every eight hours | Two to four weeks |
Maintenance phase | ||
All infections | Trimethoprim-sulfamethoxazole one DS tablet twice daily | One year |
If sulfa allergic | Doxycycline 100 mg PO twice daily PLUS Hydroxychloroquine 200 mg PO thrice daily | One year |
Therapy for relapse | ||
Initial phase* | Penicillin G 4 million units IV every four hours OR Ceftriaxone 2 g IV twice daily | Four weeks |
Maintenance phase | Doxycycline 100 mg PO twice daily PLUS hydroxychloroquine 200 mg PO thrice daily OR Trimethoprim-sulfamethoxazole one DS tablet twice daily for one year | One year |