Rates of syphilis in Saskatchewan are two to three times higher than the national rate; rates of syphilis in Saskatchewan increased by 891% from 2016 to 2020.
Penicillin G is the only known effective antimicrobial for preventing congenital syphilis and treating fetal infection.
Penicillin desensitization followed by treatment with penicillin should strongly be considered in people who are pregnant with penicillin allergies.
There is no satisfactory alternative to penicillin for treatment of syphilis in pregnancy; insufficient data exist to recommend ceftriaxone or other cephalosporins for treatment of maternal infection or prevention of congenital syphilis.
Macrolides such as erythromycin or azithromycin should not be used to treat syphilis in pregnancy given neither reliably cures maternal infection nor treats an infected fetus.
Doxycycline is contra-indicated during second or third
trimester of pregnancy.