* Penicillin is the only antibiotic recommended for the treatment of syphilis during pregnancy.
* The recommended treatment for TPHA negative with positive VDRL in pregnancy is penicillin G benzathine, 2.4 million units IM, as a single dose.
* If the patient is allergic to penicillin, erythromycin may be used, but it is less effective than penicillin and should only be used if the patient cannot tolerate penicillin. Follow-up serology should be done at 1, 3, 6, and 12 months.
* The infant should be evaluated for congenital syphilis and treated if necessary.