Pharmacokinetics of a three-dose regimen of intramuscular benzathine penicillin G in pregnant women with syphilis

Syphilis remains a global public health concern, particularly in pregnancy due to the risk of congenital syphilis. The WHO recommends benzathine penicillin G (BPG) as the standard treatment in pregnant women, whilst the optimal dosing strategy has not been established, particularly in relation to the impact of gestational age. This study sought to characterize the pharmacokinetics (PK) of a three-dose regimen of intramuscular BPG, given at weekly intervals, in pregnant women with syphilis.

Citation:
Birru EM, Salman S, Page-Sharp M, Baye C, Manning L, Moore BR, Batty KT. Pharmacokinetics of a three-dose regimen of intramuscular benzathine penicillin G in pregnant women with syphilis. J Antimicrob Chemother. 2026;81(5).

Keywords:
Anti-bacterial agent; administration; dosage; pharmacokinetics; chromatography; Ethiopa; injections; intramuscular; penicillin G benzathine; pregnancy; syphilis

Abstract:
Syphilis remains a global public health concern, particularly in pregnancy due to the risk of congenital syphilis. The WHO recommends benzathine penicillin G (BPG) as the standard treatment in pregnant women, whilst the optimal dosing strategy has not been established, particularly in relation to the impact of gestational age. This study sought to characterize the pharmacokinetics (PK) of a three-dose regimen of intramuscular BPG, given at weekly intervals, in pregnant women with syphilis.