What is the recommended first line treatment for Congenital Syphilis?

Congenital syphilis, which occurs when a mother with syphilis passes the infection to her baby during pregnancy, requires prompt and effective treatment to prevent severe complications in infants. The recommended first-line treatment for congenital syphilis is Aqueous Crystalline Penicillin G.

This formulation of penicillin is preferred because it is highly effective against Treponema pallidum, the bacterium that causes syphilis. Aqueous Crystalline Penicillin G achieves high blood levels that are necessary to treat the infection effectively in infants. The dosing and administration route are particularly important, as treating infants requires careful consideration of possible adverse effects and ensuring adequate treatment duration.

In contrast, while Penicillin G Benzathine is used for treating adult syphilis, it's not the ideal choice for congenital syphilis due to its prolonged action and lower peak serum levels, which are not sufficient for adequately treating an active infection in newborns.

Metronidazole is not effective against Treponema pallidum, and Ceftriaxone, although it has a broad spectrum of activity, is not the first-line choice for syphilis and does not have the historical and clinical backing that penicillin does in this context. Hence, Aqueous